9/4/2026

[Spay/Neuter Waiver - Temporary] Your newly adopted pet has been diagnosed with an INJURY and the staff veterinarians are issuing a TEMPORARY waiver from the spay/neuter requirements of the City of NY. Follow up care at your regular veterinarian is recommended to ensure continued treatment through to the resolution of the issue. At the time of a full recovery you may choose to have your veterinarian perform the spay/neuter surgery, or make provisions to return the pet to ACC for sterilization.

9/4/2026

DVM Intake Exam Estimated age: 5 years Microchip noted on Intake? Positive History: Owner Surrender Subjective: BAR. MM pink, moist, CRT <2 sec Observed Behavior - Orange; Generally, appearing social and friendly, trying to give kisses and seeking attention and affection from people during intake; however medically, limited ability to thoroughly examine, body tense, becomes reactive and attempts to bite at times when handled (ears, back), suspected secondary to back pain. Unable to muzzle without sedation. Sedation needed for Intake; muzzled during recovery. Is there evidence of suspected cruelty? - No Objective: P = 120 hr (premed) R = 32 rr (premed) BCS 5/9 Wt = 16.4 lbs EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Severe dental disease with dental calculus, gingival recession, probable exposed bone and gingivitis - upper maxillary posterior dentition most severely affected PLN: No enlargements noted H/L: NSR, no apparent murmur, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: MI (2 testicles descended) MSI: Ambulatory x 4 with significant bilateral hindlimb paresis and ataxia. Dermal abrasions on dorsal aspect of both hind paws and distal forelimbs. CNS: Mentation appropriate. Bilateral hindlimb conscious proprioceptive deficits. Assessment: *Suspect Intervertebral Disc Disease (IVDD)*: vs. other spinal cord disease. *Bilateral Hindlimb Paresis and Ataxia*: with proprioceptive deficits. *Pain*: Suspected spinal pain *Dermal Abrasions*: Secondary to neurologic deficits. *Severe Dental Disease* Prognosis: Fair, pending advanced care Plan: Standard Intake Procedures for Dogs Performed -Sedation protocol: Dexmedetomidine (0.08 mL), methadone (0.22 mL), ketamine (100 mg/mL, 0.08 mL) IM; additional dexmedetomidine (0.04 mL) and ketamine (0.04 mL) IM given. Reversal with atipamezole (0.12 mL) IM. -Radiographs (spine, pelvis, hindlimbs): No significant abnormalities on initial review; submitted for radiology consult. -Bloodwork: Adult wellness plus panel pending. -Carprofen (50 mg/mL): 0.65 mL (4.4 mg/kg) SQ, 24-hour dose. -Gabapentin: 200 mg PO BID, indefinitely. -Carprofen: scheduled 25 mg PO SID x 14 days initially, to start tomorrow and adjusted as needed following bloodwork review and progression. -Recommend New Hope placement ASAP. Emailed plea 9/4. -Strong recommendation for neurology consultation after placement. Anticipate possible advanced diagnostics (e.g., MRI), potential surgery, and intensive supportive care, including strict cage rest for at least 4-6 weeks. Short leash walks only for elimination. -Recommend dental care post placement. -Recheck tomorrow; BW review and radiology consult review when in. Check in on pathway. SURGERY: Temporary waiver d/t suspect spinal disease

9/4/2026

Radiology Consultation Request 5-year-old MI dog, 16.4 lb, owner surrender due to "paralysis", presenting with suspected spinal pain and significant bilateral pelvic-limb paresis and proprioceptive ataxia. Patient remains ambulatory x4 with bilateral pelvic-limb conscious proprioceptive deficits and dermal abrasions over the dorsal hind paws/distal forelimbs, suspected secondary to neurologic deficits/abnormal gait. Unable to adequately neurolocalize prior to sedation due to patient behavior and reactivity with handling. Examination required sedation including methadone, further limiting subsequent pain assessment/localization. During recovery, patient appeared possibly most reactive/painful with palpation of the mid-lumbar region, although definitive localization could not be established. Spinal, pelvic, and hindlimb radiographs obtained under sedation. Please evaluate for radiographic evidence of IVDD/intervertebral disc space abnormalities, vertebral pathology, trauma, discospondylitis, neoplasia, or other potential cause for the patient's neurologic deficits and suspected spinal pain.

9/5/2026

Recheck, bw results S/O: BAR, eating well, no c/s/v/d noted; friendly initially with distance decreasing behavior and loose body, allows me to remove from kennel and examine hindlimbs/body, but upon picking up to put back in kennel he begins biting/snapping without warning (ro pain) EENT: No ocular or nasal discharge LUNGS: Panting, eupneic at rest MSI: Amb x 4 with severe HL paresis and ataxia, LHL more severe than RHL, LHL crosses over, bilateral HL muscle atrophy CNS: Appropriate mentation, delayed CP RHL, absent to delayed CP LHL CBC: Hct 35.4 (L), monocytes 0.818 (H), eosinophils 0.028 (L) CHEM/T4: wnl A: HL ataxia/paresis - ro IVDD vs other Severe dental disease Senior pet P: Continue gabapentin and carprofen CTM closely while at QACC Seek placement ASAP - unable to provide level of care in shelter

9/6/2026

Radiology consult CONCLUSIONS: - T9-10, L1-2, and possible C6-7 intervertebral disc disease. A compressive myelopathy at 1 or more of these sites could explain the reported pelvic limb proprioceptive deficits. However, definitive localization of clinically significant myelopathy/radiculopathy (compressive or non-compressive) is unable to be provided based solely on survey radiographs, and further imaging is recommended prior to considering surgical or other invasive intervention. - Mild bilateral coxofemoral osteoarthrosis with femoral head subluxation. This is consistent with underlying hip dysplasia. While this could explain a contributing factor to pelvic limb pain/lameness, this would not explain the reported proprioceptive deficits in the pelvic limbs. - Bilateral fragmentation of the lateral fabella of the stifles. This may represent an incidental finding (i.e. multipartite fabella), though a pathologic cause such as previous trauma and/or gastrocnemius musculotendinopathy is also considered. Similar to the above conclusion, this may contribute to pelvic limb lameness but would not cause neurologic deficits. - Mild left pelvic limb muscle atrophy (disuse vs neurogenic). - Gastric content is consistent with normal ingesta. Foreign material is considered less likely but cannot be excluded based on radiographic appearance. - Moderate prostatomegaly. This is highly likely a normal variant (benign prostatic hypertrophy) given this patient's signalment. - The thorax and abdomen are otherwise radiographically unremarkable. RECOMMENDATIONS: - If spinal cord injury/disorder remains a primary concern for this patient's clinical signs, magnetic resonance imaging (MRI) is recommended. Prior to proceeding with MRI, localization of the affected spinal cord segment(s) is recommended. If warranted, a repeat neurologic examination and/or consultation with a veterinary neurologist may be beneficial to further localize the probable site of cord injury. - If advanced imaging is not available, myelography can also be considered, though familiarity and comfort with sterile contrast handling, dosing, subarachnoid administration and quick image acquisition is a requirement for success of this procedure. - In the interim, medical management of suspected acute/compressive myelopathy is appropriate and includes but is not limited to cage-rest, anti-inflammatory medications +/- muscle relaxants. - Consider orthopedic evaluation if clinical signs of hip pain become apparent after addressing the neurologic deficits. OK to continue on ARL pathway so long as P remains comfortable -- if unable to control pain associated with IVDD / OA consider EHR DVM recheck pain / pathway 9/8

upon intake, handled minimally due to being a medical priority.