5/16/2026

It is the policy of ACC not to perform surgery on any animal over the age of 8-10 years due to the higher risks incurred in a shelter setting. The veterinarian is hereby issuing a permanent spay/neuter waiver, from the spay/neuter requirements of the City of NY due to the estimated age of this animal. ACC does recommend you consult with your veterinarian to determine if surgical sterilization is appropriate.

5/16/2026

DVM Intake Exam Estimated age: 9 years Microchip noted on Intake? Negative History: Stray, transferred from an emergency hospital where he had been since May 13th. QAR MM pink, moist, CRT <2 sec Observed Behavior - Blue; Able to examine, nervous, body tense, not taking treats, vocalizing/howling Is there evidence of suspected cruelty? - No Objective: P = 110 hr R = 30 rr BCS 5/9 Wt = 14 lbs EENT: Mild lenticular sclerosis noted. Right ear is painful and has moderate to severe erythema, swelling, and purulent yellow-brown discharge. Left ear is mildly affected. No nasal or ocular discharge noted. Oral Exam: Moderate periodontal disease noted. PLN: No enlargements noted H/L: NSR, no apparent murmur, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: MI, bilateral inguinal cryptorchid MSI: Ambulatory x 4, graying of the face, mildly overgrown nails, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate. Right-sided hemiparesis with proprioceptive deficits, worse in the right hindlimb. Assessment: *Right-sided hemiparesis*: Central nervous system localization. Differentials include cerebrovascular accident, inflammatory/infectious encephalitis, traumatic injury, neoplasia, or less likely, asymmetric intervertebral disc disease. *Otitis Externa*: Bilateral, severe in right ear. *Inguinal Cryptorchidism*: Incidental finding. *Periodontal Disease*: Moderate, chronic. Prognosis: Fair Plan: -NSAID panel at ER: WNL except for mildly elevated AST (53). -Buprenorphine 0.02 mg/kg (0.42 mL of 0.3 mg/mL) IV for ear pain analgesia and mild sedation. -Thorough ear cleaning performed. -Simplera applied to both ears. -Nail trim performed. -Gabapentin 100 mg PO BID indefinitely. -Trazodone 50 mg PO BID indefinitely. -Ear recheck 1 week. -House in Medical; monitoring for change or progression of hemiparesis/neurological/NM disease. -Patient should be carried, not walked outside, but once outside OK to have short and limited walks on leash for some enrichment, activity and elimination. -Fit for harness. -Recommend New Hope placement for ongoing medical care, including a veterinary neurology consultation. SURGERY: Permanent waiver d/t age and medical condition

5/19/2026

Recheck exam S/O: BAR, extremely vocal in kennel, quiet out of kennel, eating, no c/s/v/d noted EENT: No ocular or nasal discharge ORAL: Gingivitis and moderate to severe tartar LUNGS: Eupneic MSI: Ambulatory x 4 with CP deficits and intermittent knuckling of RFL, CP intact RHL UG: IM male, two inguinal testicles palpated CNS: Appropriate mentation A: Right sided hemiparesis - improved; RFL deficits appreciated today Otitis externa - treated at intake Bilateral inguinal cryptorchid Periodontal disease Vocalization in kennel - ro FAS +/- cognitive dysfunction vs other P: Continue trazodone and gabapentin Seek placement for additional diagnostics (neuro consult) vs palliative care CTM closely while at QACC

5/21/2026

Recheck S/O: BAR, calmer/quieter in kennel today, allows all handling, eating well, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Ambulatory x 4 with intermittent knuckling of RFL and mild ataxia vs hypermetric gait with RHL A: Neuro deficits at RFL > RHL Inguinal cryptorchid, bilateral Periodontal disease Vocalization in kennel - improved P: Continue current treatment plan CTM on rounds and seek placement for neuro consult vs palliative care.

5/23/2026

Simplera applied 1 week ago, cannot clean or apply any medications at the moment.

5/23/2026

Progress exam S/O: QAR in kennel today, allows all handling, low appetite reported today; no c/s/v/d noted. Normal u/d. EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Ambulatory x 4 with intermittent knuckling of RFL and mild ataxia with RHL; RFL - delayed to absent posturals; RHL delayed posturals A: Right-sided hemiparesis - neuro deficits RFL > RHL - appears stable, not progressive Inguinal cryptorchid, bilateral Periodontal disease Vocalization in kennel - none observed today Low appetite - new P: Continue with gabapentin and trazodone CTM daily on rounds Brief appetite recheck tomorrow Add to ARL due to low appetite and need for continued care/management

5/24/2026

Reason for recheck: poor appetite reported BAR, vocalizing and wagging tail at front of kennel FS 7 reported Inconsistent appetite- alternates between eating none and eating some. Ate HVTs (spam, dry kitten food) well Plan: Start medical feedings q12 indefinitely Monitor diarrhea, start psyllium husk if diarrhea continues and appetite is consistent

5/24/2026

Recheck senior dog with right sided neuro deficits. Appetite ok? Has not been eating well, added to ARL. Rechecked with Vet 2048. Animal eating medical feedings.