8/4/2026

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.

8/4/2026

DVM Intake Exam Estimated age: 9-12 years Microchip noted on Intake? scanned neg History: stray Subjective: Observed Behavior -amenable to handling for most of exam and tasks, made a bite attempt towards the end Is there evidence of suspected cruelty? no Objective: BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: severe dental disease, missing multiple incisors, multiple discolored teeth PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: intact male MSI: Ambulatory x 4-stiff gait, skin free of parasites, no masses noted, matted (partially shaved), bleeding wound on right shoulder with flap of skin CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: perianal area thickened Assessment: Wound Dental disease Prognosis: good Plan: DVM intake and tasks Convenia 0.9 mls sq Carprofen 0.75 mls sq triple antibiotic bid recheck tomorrow, may need to be closed vs 2nd intention healing SURGERY: Permanent waiver due to age

8/6/2026

Progress exam Reported be care staff to be lethargic, unable to be roused/not moving in kennel at ~3.30pm. Was BAR this morning and went out on walk without issue. Brought immediately back to medical for evaluation. S/O: HR 90 bpm, RR 32, T 100.9. Dull to QAR - sedated-appearance. When 'woken up' and offered food would eagerly eat ALL of food. Pink-lilac MM with crt<2secs, tacky mm. Moderately prolonged neck skin tent. No ocular or nasal discharge. No murmurs or arrhythmias noted. Neuro: slight hyperaesthesia when touched, wide based stance with ataxic gait; positive menace OU; markedly delayed HL posturals. A: Acute neurological deficits - r/o CNS lesion vs THC toxicity -Geriatric -Healing wound on R shoulder -Severe dental disease P: House in Medical ICU Blood bloodwork for in-house CBC/CHem/T4 Start: -IVFT LRS 45ml/hr (5ml/kg/hr) until 6.30pm, then d/c overnight -Vitamin B12 0.4ml SQ once -Cerenia 0.9ml SQ once *Recheck tomorrow in AM: -If BAR and still eating recommend ARL/immediate placement -If not eating, more lethargic or any neuro deficits continued recommend EHR

8/7/2026

Bloodwork: CBC: RBCs 5.25 low HCT 31.9% low MCV 60.8 low MCHC 41.1 high Retic 7.7 low Lymph 0.4 low Mono 1.36 high Chemistry: Creat 1.5 WNL BUN 41 high Phosph 7.6 high Sodium 140 low ALT 301 high GGT 12 high TT4 0.7 low A: Non-regenerative anemia r/o chronic disease, inflamm/neoplasia Lymphopenia - stress leukogram, glucocorticoids Monocytosis - inflammation, stress leuk Azotemia - pre-renal/dehydration, renal Mildly elevated ALT, GGT - r/o hepatobiliary dx Hyperphosphatemia - artifact, neoplasia, increased intestinal absorption, decreased urinary excretion P: Treatment plan as previously discussed CTM closely for changes

8/7/2026

Progress exam Recheck - noted to have lethargy and neurologic abnormalities on 8/6 afternoon. Patient was placed on IVF and monitored overnight. S/O: BAR Neurologically appropriate today: positive menace OU, PLR intact and responsive, mentation is responsive and appropriate. Patient was slow to stand and had difficulty getting up on hind legs. Once standing, patient was able to ambulate around treatment room (insistent on sniffing the floor for treats) without issues. Generalized stilted gait, decreased ROM in hips and hind end muscle wasting. A: Acute neurological deficits - r/o CNS lesion vs THC toxicity. Appears resolved this morning. - Arthritis -Geriatric -Healing wound on R shoulder -Severe dental disease P: Plan to d/c fluids and supportive care. Patient is BAR and appears to be eating at this time. Continue to monitor in ICU for recurrence of clinical signs. Recheck placed for 8/8 to evaluate QOL. Can move out of ICU if BAR and continues to do well. If another neuro episode occurs, EHR recommended. Place animal on ARL list. Can re-assess status and QOL (consider deadline) during recurrent rechecks.

8/8/2026

Recheck mentation and QOL BAR, patient is mentally intact and alert, appropriate mentation. Eating well overnight. No recurrence of neurologic episodes. R/O acute/isolated incident vs. will recur in the future. P: OK to move out of ICU at this time. Keep patient on ARL list, no deadline needed at this time.

8/8/2026

Recheck wound. See previous exam notes regarding mentation. Wound is healing well by second intention. Flap of skin has necrosed and will fall off on own. No surgical fixation needed or additional medications. Continue to monitor, no further steps needed.

Upon intake Willhelm was very friendly and docile around counselors allowing all handling such as scanning for microchip, collaring and walking back to medical. He was then vaccinated and placed into his kennel. All done without any concerns.