11/9/2024

Your newly adopted pet has been diagnosed with heart murmur and the staff veterinarians are issuing a PERMANENT waiver from the spay/neuter requirements of the City of NY. ACC does not have the facility to safely sterilize your pet with his/her current condition. However, your veterinarian will provide consultation on whether this procedure can or should be performed under their supervision. Follow up care at your regular veterinarian is recommended to ensure continued treatment and proper oversight of your pet's health. All costs for follow up care and subsequent surgery is at the expense of the adopter.

11/9/2024

DVM Intake Exam Estimated age: 4-6yrs Is this an orphan kitten? no Is the kitten eating on own? n/a Is the kitten suckling? n/a Microchip noted on Intake? negative History: stray Subjective: Dog is BARH Observed Behavior - immediately social, wagging tail, panting, moving around but allows handling, readily accepts treats Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective T = N/A P = N/A R = pant BCS 5/9 EENT: Eyes clear, ears waxy debris AU, no nasal or ocular discharge noted Oral Exam: Mild dental dz PLN: No enlargements noted H/L: NSR, Grade IV+/VI, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: Female intact MSI: Ambulatory x 4, straight/stiff through stifles, skin free of parasites, no masses noted, dry flaky skin, nails overgrown and starting to curl towards pads CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: NE Wood's Lamp Exam: NE Assessment Approx 4-6yr old intact female medium-large mixed breed Heart murmur Otitis externa, AU Dermatitis Prognosis: Guarded Plan: Completed intake tasks Trazodone (100mg): 2 tabs PO at 12pm Plan to do nail trim and blood draw +/- clean ears after lunch Recommend echocardiogram on placement SURGERY: Permanent waiver due to heart murmur

11/12/2024

Progress exam: reported to be limping S/O: BAR, wagging tail, loves treats EENT: clear eyes & ears, no nasal or ocular dc MSI: A x 4 but walks with stiff gait in hind legs and has a hyperextended tarsus on the LHL resulting in her walking up on her toes. Also has hyperkeratotic lesions with long keratin fronds on all of her paw pads & overgrown nails. P very sensitive to having her paws touched & very limited range of motion in the tarsi bilaterally. A: hyperkeratotic lesions on paw pads hyperextended left tarsus with limited range of motion (r/o chronic changes associated with dystrophic limbs and ligament damage +/- acute injury) P: Start on carprofen 4mg/kg SID x 4 days and gabapentin 10mg/kg PO BID for pain; recheck in 48 hours to see if she will allow more in-depth ortho exam; if not, plan to sedate for ortho exam, rads +/- trim nails and hyperkeratotic lesions

11/14/2024

progress Exam recheck for stiff gait, r/o orthopedic request for sedation, ortho exam and XR study Hx HM currently on carprofen 100mg PO SID Objective BARH wags tail and solicits attention mm pink P = WNL R = WNL BCS 6/9 EENT: Eyes clear, ears large amount of waxy dry debris, no significant odor no nasal or ocular discharge noted Oral Exam: adult dentition, scant dental tartar PLN: No enlargements noted H/L: NSR, IV/VI bilat HM CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G:female, no spay scar, hyperplastic teats and vulva, clear discharge from lower caudalmost teat MSI: Ambulatory x 4, stiff short strided gait x 4, hocks hyperextended skin free of parasites, dry coat, a few areas of patchy flaky skin no masses noted reduced ROM bilat carpi, phalangeal joints on all four paws, hocks All nails overgrown and interfere with gait CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal:soiled sedated ( dexdomitor/ torb, reversed with antisedan) ortho exam: hips reduced ROM, left especially on extension. pet reacted by snarling with left hip extension both hips severe reduced adduction no cranial drawer of stifles, both have crepitus worse left than right, medial buttressing Assessment severe left hip dysplasia, and femoral neck osteopathy partial arthrodesis of metacarpophalangeal joints, metatarsophalangeal joints, tarsi, carpi cardiomegaly, left atrial enlargement particularly Prognosis: fair, will need lifelong management of orthopedic changes heart murmur Plan: cleaned ears , anus and feet nail trim two view rads: carpi: bilaterally fused carpal bones, no joint or disk spaces seen tarsi: bilaterally fused tarsal bones, no joint or disk spaces seen metacarpophalangeal joints, metatarsophalangeal joints decreeased joint spaces hips: right hip good femoral head/ acetabular coverage. Left severe incongruity femoral head and acetabular rim, femoral head appears enlarged and irregular. Femoral neck shortened, cortical irregularity stifles: severe osteophytic changes on both sides of joints, bilaterally thorax one view VD: greatly enlarged cardiac silhouette with enlargement of right atrium lungs clear rec continue carprofen at half dose daily 50mg PO SID x 2 weeks recheck comfort in one week

11/14/2024

pt sedated with dex/torb 0.5 mls IM/0.5 mls IM rads taken

11/21/2024

Brief recheck - BAR, active, no c/s/v/d noted, eupneic. Ambulatory x 4 with abnormal, short gait but no notable limping. LHL up on toes with tarsus in extension more notably than other limbs. Tenses when attempting handling/exam of limbs - did not force the issue. Plan: Continue rimadyl and CTM while at QACC. Concern for multiple severe orthopedic issues as well as presumed cardiomyopathy. Recommend cardio and ortho consults with placement.