11/26/2025

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.

11/26/2025

DVM Intake Exam Estimated age: 15 years Microchip noted on Intake? Positive History: Agency, brought in by an Animal Control Officer on 11/25/2025. The patient received FVRCP and Rabies vaccinations, Capstar, and Frontline on 11/25/2025. QAR MM pink, moist, CRT <2 sec Observed Behavior - Green; Easily examined, took treats readily, relaxed, seeking human attention and affection Evidence of Cruelty seen - No Evidence of Trauma seen – No Evidence of Neglect- No Objective: P = 140 hr R = 30 rr BCS 3/9 Wt = 5.34 lbs EENT: Moderate iris atrophy noted bilaterally. Anisocoria is present, with the left pupil appearing more dilated than the right. A slight pupillary light reflex was observed in both eyes. The menace response was reduced in the left eye. Ears are clean, no nasal discharge noted. Oral Exam: Severe dental disease is present, characterized by significant dental calculus and gingival recession. The majority of teeth are absent. Remaining dentition includes the right maxillary and mandibular canines, the left maxillary canine, and some caudal maxillary molars. PLN: No enlargements noted H/L: A grade 5/6 holosystolic heart murmur with a palpable thrill was auscultated, with the point of maximal intensity over the sternum. Femoral pulses were faint but symmetric and difficult to palpate. Lungs clear, eupneic. ABD: Moderately distended and non-painful. Palpation and a brief ultrasound examination revealed findings consistent with abdominal effusion (ascites). U/G: FI (no spay scar or green spay tattoo observed) MSI: Ambulatory x 4, skin has evidence of flea dirt, healthy hair coat otherwise. CNS: Mentation appropriate - neurologic abnormalities noted, including anisocoria and an asymmetric menace response. Assessment: Geriatric with suspect chronic conditions -Severe heart disease: Grade 5/6 heart murmur with a palpable thrill is indicative of severe underlying cardiac pathology, such as hypertrophic cardiomyopathy. -Congestive heart failure: Suspected secondary to severe heart disease, evidenced by the presence of ascites. -Anemia: Bloodwork confirms a mild to moderate anemia, likely chronic in nature. -Neurologic abnormalities: Anisocoria and asymmetric menace response are noted. Differentials include hypertensive encephalopathy, intracranial neoplasia, or a past thromboembolic event. -Severe dental disease: Chronic and extensive. -Underweight: BCS of 3/9. -Flea infestation: Evidence of flea dirt on skin. *NEW DIAGNOSTIC INFORMATION*: -CBC/Chem: Revealed anemia (RBC 5.15, HCT 20.8, HGB 6.7), monocytosis (1.13), elevated GGT (5), and low K (3.4). -Total T4: 1.6 ug/dL (within normal limits), making hyperthyroidism less likely. -Feline proBNP SNAP test: Normal. -Abdominal ultrasound (brief): Confirmed the presence of free fluid in the abdomen. Prognosis: Guarded Plan: Standard Intake Procedures for Cats Performed Fleas/flea dirt noted and Capstar administered on 11/25/2025. *OTHER RECOMMENDATIONS, FOLLOW-UP CARE*: -Continue to monitor appetite, hydration, and comfort level. -Provide palatable food and fresh water. -Re-evaluate patient status in two days (11/28/2025) for consideration of placement in the at-risk category for adoption given the multiple severe medical conditions. SURGERY: Permanent waiver d/t age Heart murmur detected: Grade 5/6

11/28/2025

recheck geriatric cat with HM S/O BAR, comes to the front of the kennel, food trays moderately disturbed, no c/s/v/d appreciated, sitting in bed when approached EENT: no ocular or nasal dc, iris trophy HL: 1-2/6 holosystolic HM, eupneic, lungs clear GA/GU: npm, doughy feel to abdomen with moderate distention MSI: amb x 4, good skin turgor A. HM- sounds closer to 1-2 than 5/6 Ascites - no fluids wave appreciated or noted on rads Geriatric P. Moved p over to ICU for closer monitoring abdominal rads- no obvious fluid Recheck in 2 days- consider possible p doesn't have CHF vs open

12/1/2025

recheck geriatric cat S/O BAR, comes up to the front of the kennel purring, no c/v/s/d appreciated, food trays empty, normal litter clumping in LB EENT: no ocular or nasal dc HL: nma, purring, PSS, clear bilaterally, eupneic GA/GU: npm, doughy abdomen MSI: amb x 4, good skin turgor A. CHF- no signs appreciated again HM- purring loudly, not appreciated, if present is low grade without clinical signs Geriatric Anemia r/o chronic disease P. P is doing well in ICU-okay to move out when space Permanent surgery waiver d/t age recheck PCV or CBC in 2 weeks to monitor anemia Recheck in 3 days

12/4/2025

Recheck geriatric cat- noted to have abdominal effusion and significant heart murmur at intake, but has been doing well since then S/O: BAR, active and vocal in kennel, attention seeking; great appetite, no c/s/v/d noted EENT: No ocular or nasal discharge, iris atrophy consistent with age, possible anisocoria (very mild) H/L: NMA, SSP; lungs eupneic ABD: Slight distention, very tense, no obvious masses or pain MSI: Ambulatory x 4, healthy haircoat CNS: Appropriate mentation A: Heart murmur - no appreciated today Geriatric cat Mild abd distention/tense - does not feel like fluid Severe dental disease Possible anisocoria Underweight Anemia P: Clinically doing well - active and eating great, seeks attention. Concern for underlying undiagnosed disease in geriatric cat, long-term prognosis guarded. Seek placement for palliative care vs additional diagnostics

12/7/2025

recheck geriatric, anemic, dental dz S/O Q-BAR, no c/s/v/d, A+A, comes to the front for interaction, dry food appears untouched, medical feed and wet food mostly eaten EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4, good skin tent A. Geriatric Dental dz Anemic Inappetence r/o difficulty eating hard food P. Start medical feeds BID x 3 days Monitoring log Signage for ensuring has access to wet food recheck in 4 days