7/7/2025

DVM Intake Exam Estimated age: 7-10 years Microchip noted on Intake? scanned negative History: stray Subjective: bar Observed Behavior -friendly, amenable to gentle handling, does not like restraint Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective BCS 4/9 EENT: nuclear sclerosis ou, erythema au, no nasal or ocular discharge noted Oral Exam: dentition free of tartar PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: pronounced mammary glands, multiple mammary masses with the largest left associated with most cranial nipple MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: grossly normal Assessment Otitis externa Mammary mass Prognosis: fair Plan: DVM intake and tasks Simplera ou awaiting sort SURGERY: Okay for surgery

7/11/2025

Behavior team reports pacing, panting, red face/eyes during assessment; lunging at dogs during walks. Start trazodone 9 mg/kg PO BID and clonidine 0.01 mg/kg PO BID.

7/15/2025

Pre-surgical exam, anesthesia, and surgery performed by an offsite vet. Medical record uploaded to Vet Documents. Green linear tattoo placed lateral to incision. GIVE: 1 tablet of Rimadyl 100 mg by mouth for 4 days starting the day after surgery Notes: Firm subq masses in the left lower and upper mammary chain

7/17/2025

Episode reported by behavior team: "ACS staff just told me that Selly 231243 possible had a seizure this morning, and when being walked outside began to fall over and do a swim motion with her paws while on the ground. This lasted around 10 seconds and staff were not able to record it, but she recovered fine and continued her walk. Just a bit ago, Selly was chewing on her rawhide as normal in kennel and when I coaxed her over to kennel, she began to run right into the kennel door, and seemed to have trouble finding me, I used a treat to coax her and leashed her as normal. Once I took her out of the kennel, she began to pull mildly and run into objects in the hallway, and briefly fell over on her side, but recovered almost immediately." S/O: BAR, active, allows handling, collar and neck lead - mild pulling when walked from kennel to medical; coughing during exam, no v/d/s noted EENT: No ocular or nasal discharge H/L: NMA, SSP; Eupneic MSI: Ambulatory x 4, no notable lameness CNS: Appropriate mentation, menace positive OU, no ataxia or bumping into things A: Suspect syncopal vs vagal episode Coughing - ro secondary to pulling on neck lead vs emerging CIRDC P: Asked behavior team to place harness CTM closely on rounds, recheck tomorrow

7/18/2025

brought into medical as ACS, noted to have "collapsed" on walk, per staff was conscious after a second of appearing non-responsive, got back up quickly afterwards but then appeared to fall over again while walking, at one point hind legs appears to be kicking. S/O BAR, A+A, C++, no s/v/d appreciated, solicits attn, take HVT EENT: mild epiphora OU, moderate thin active mucoserous nasal dc, mm pm <2 HL: nma, clear bilat, eupneic MSI: amb x 4, good skin turgor Neuro: Mentation appropriate, CNs intact, no CP deficits, no ataxia, able to walk freely around medical- no gait deficits A. CIRDC Syncopal vs vagal episode P. Start doxy 10mg/kg PO SID x 10 days Start MF BID x 3 days Move me to iso signage hung recheck on day 3 7 10 CTM appetite closely on rounds

7/20/2025

[Post Surgical Exam] Attitude/demeanor: [BAR] Appetite: [eating well] C/S/V/D: [none] Incision site: [no swelling, bruising, or bleeding; sutures appear intact] Pain level: [appears comfortable] Licking, chewing, or biting surgical site noted: [no] Additional notes: [N/A] VA2397

7/22/2025

Recheck CIRDC day 4 S/O: BAR, active, food in kennel uneaten, not consistently eating meds, coughing, no v/d/s noted. Ate sausages readily from my hand. EENT: Mild serous nasal discharge, no ocular discharge LUNGS: Persistent coughing out of kennel, otherwise eupneic MSI: Ambulatory x 4 A: CIRDC Hyporexia vs not eating meds P: D/c behavior medications temporarily while treating CIRDC Extend medical feedings BID Made note to handfeed doxy in HV treats CTM on rounds, recheck appeite/eating meds in 2 days

7/24/2025

recheck CIRDC, taking meds? S/O BAR, comes to the front of the kennel, no c/s/v/d appreciated, medical feeding empty, meds and regular food appear untouched EENT: no ocular dc, mild serous nasal dc HL: eupneic MSI: amb x 4 A. CIRDC with inappetence P. To try to offer p meds in HVTs Recheck as scheduled, mild signs aTT but p has been finicky with meds, check to see if still taking meds at next recheck, if not consider change to injectables CTM while at QACC

7/25/2025

Progress exam: CIRDC day 7 recheck Subjective: BAR, no C/V/D. Sneezing noted. Untouched food & med feeds, no medication tray in kennel. Objective: EYES: Clear, no discharge LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: mild mucoid discharge MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed CIRDC PLAN: Per standing orders -Alert dvm about appetite -CTM

7/26/2025

Progress exam S/O: BAR, mild serous nasal discharge; coughed twice while cageside, eupneic. Pink mm. Eagerly eating spam and seen eating dry food in kennel. Meds untouched, but then offered in spam and ate well. A: CIRDC - stable, improving Anorexia - improved P: Continue to monitor Recheck CIRDC day 10

7/29/2025

Recheck CIRDC day 11 - last day doxycycline yesterday S/O: BAR, active and wiggly in kennel, med tray empty, sneezing, no c/v/d/ noted EENT: Mild mucoserous nasal discharge, no ocular discharge LUNGS: Eupneic CNS: Appropriate mentation A: CIRDC P: Extend doxycycline 10 mg/kg PO SID x 5 days and recheck CIRDC day 16; CTM on rounds

8/3/2025

recheck CIRDC, today is day 16 S/O BAR, comes up to the front of the kennel, no v/d/c, S+, moderate active serous nasal dc, no ocular dc, eupneic, med tray empty A. CIRDC- lingering signs vs active infection P. Extend doxy thru 8/7 CTM and recheck for resolution 8/7- not electing to change to enro yet as p has shown improvement in signs and current signs mild

8/7/2025

Progress exam: CIRDC recheck Subjective: BAR, no C/S/V/D. AS:1 Objective: EYES: Clear, no discharge LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: no discharge MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed CIRDC appears resolved PLAN: Per standing orders -Move out of iso, signage placed. -CTM on daily rounds

8/13/2025

Behavior team reports reoccurrence of anxiety behaviors - panting, pacing, difficulty focusing. Previously on trazodone 9 mg/kg PO BID and clonidine 0.01 mg/kg PO BID, but discontinued due to poor appetite when diagnosed with CIRDC. Plan: Okay to restart trazodone and clonidine at previous doses, CTM while at QACC

9/28/2025

S/O: BAR EENT: no nasal or ocular discharge MS: ambulatory x 4, clean coat Integ: left mammary (most cranial under left front leg) irritated and starting to rupture Rec/ mass removal as most likely malignant

9/29/2025

BAR going on trial adoption Recommend/ mammary chain removal

9/29/2025

DVM Intake Exam Estimated age: dentition and conformation consistent w prior age reported of 7-10 years Microchip noted on Intake? scanned positive History: return from TA Subjective: BAR Observed Behavior -solicits attn, allowed for handling Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective BCS 4.5/9 EENT: no ocular dc, lenticular sclerosis OU, Au cl, no nasal or ocular discharge noted Oral Exam: moderate wear and staining to visible dentition PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: pronounced mammary glands, multiple mammary masses with the largest left associated with most cranial nipple- mild-mod erythema and swelling to this gland, scant serous dc MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment MGTs - one appears to be about to rupture Prognosis: fair Plan: intake exam and tasks seek placement asap as p will require surgical remove of MG mass recheck mass in 6 days SURGERY: Okay for surgery

10/2/2025

Starting gabapentin to provide some analgesia for mammary mass, and carprofen x 7 days. -gabapentin 300mg PO q12h indefinitely -carprofen 100mg PO q24h x 7 days *Seek placement ASAP, if unable to find placement, recommend EHR *Recheck comfort and mass in next 1-2 days

10/3/2025

recheck MG mass S/O BAR, A+A, no c/s/v/d appreciated EENT: no ocular or nasal dc HL: eupneic GU: MG mass on the L most cranial gland, harness is rubbing up against the mass, no d/c but some flat scabbing noticed, mild-moderate localized erythema MSI: amb x 4 A. MG tumor P. Removed harness- if p needs harness for walks will need to be padded to not irritate the gland Con't with current treatments CTM while at QACC, recheck in 5 days.

10/8/2025

Recheck mammary gland tumor, recently appearing irritated, possibly going to rupture S/O: BAR, active and allows handling, no c/s/v/d noted -Mammary gland tumor at left cranial MG - irregularly shaped and firm, small scabs appreciated in two areas otherwise stable A: Mammary gland tumors with healing scabs P: MGT appear to have improved and are stable since removing harness CTM while at QACC Recommend removal and biopsy with placement

10/10/2025

noted by the behavior staff to have "passed out" within 10 minutes during their session. No pulling was noted, no loss of conscience, no urinating/defecation. Brought back into medical for exam S/O BAR, A+A, takes treats EENT: no ocular or nasal dc HL: tachycardic, nma, clear bilaterally, nRE, panting GA/GU: mass by L most cranial MG as previously described, no d/c MSI: amb x 4, no lameness or lesions Neuro: CNs intact, intact CP but when p tries to regain balance, falls down. Appears to be bilateral, at one point p fell to the L side and began to kick legs in the air but no obviously seizure activity as was cognizant and conscience, was able to right herself with assistance A. MGT Neurological episodes/difficulty with balance r/o primary neuro vs mets from MGT vs open P. Moved patient to ICU for closer monitoring in house blood work: CBC: wnl CHEM: H ALT (364) r/o trauma, neoplasia, spurious Priority recheck tomorrow

10/11/2025

Reported to have 'passed out' yesterday. S/O: BAR, very active and playful. AS 2/3. Eupneic. Pink and moist mm. No neurological deficits, normal posturals, no ataxia. RHL toe touching lameness; main paw pad has elevated pustule and erythema, painful to touch. No inflammation or erythema of mammary masses, appear quiet. Weight today is 44.6 lbs. A: Finicky/low appetite Mammary gland tumors - stable Pustule inflammatory lesion on RHL paw pad Mildly underweight - stable Hx collapse on 10/10 - no episodes since yesterday Hx ataxia on 10/10 - resolved P: Start Carprofen 100mg PO q24h x 5 days Clean RHL foot once daily with dilute chlorhexidine until resolved Editing age to 9 years old based on appearance and dentition *On ARL seek placement *Hold in ICU for another 48-72 hours

10/14/2025

Recheck episodes of collapse and lesion on toe S/O: BAR, brought toy with her, chewing on it during exam, allows all handling EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Ambulatory x 4 with mild weight bearing RHL lameness - on digit 2 pad there is a <1cm fleshy nodule with mild scabbing/bleeding when scab pulled away; no other obvious lesions; mammary masses as previously described with healing/nearly healed wounds. A: Nodule on RHL paw pad - ro neoplasia (benign vs malignant) vs inflammatory vs other Mammary gland tumors History of multiple episodes of losing consciousness, seemed to have resolved upon switching to harness, but have reoccurred since switching back to neck lead (removed harness due to irritation/friction of MGT) - suspect partial asphyxiation secondary to pulling on neck lead +/- carotid sinus hyperactivity vs other P: Seek placement for multiple medical problems. Ideally mass removals (MGT and paw pad nodule) + biopsy. Consider replacing harness if lesions on MGT heal and repeat episodes of passing out occur CTM closely on rounds and recheck nodule on RHL in 10 days

10/16/2025

Last day of carpro for RHL lesion on paw pad S/O BAR, A+A, no c/s/v/d appreciated EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4, no appreciable lameness, small scab like lesions just before the metacarpal pad in the interdigital space, another smaller scab like lesions in the interdigital space by the metacarpal pad LHL A. MGTs Nodule on RHL - appears smaller than described prior and scabbed over, another small scab-like lesions on the LHL r/o allergies vs open Hx of episodes of collapse -r/o pulling vs open P. Okay to complete carpro course Use harness for walks - please pad with t-shirt/sweatshirt underneath so doesn't aggravated MGT CTM and recheck as needed

10/19/2025

Behavior notes that p is lame/non-weight bearing in the RHL again. Restart carpro 100mg PO SID x 7 days recheck tomorrow

10/21/2025

Issue List: - left sided irregular mammary gland tumor associated with MG #1; also on the left side small nodular MGT associated with #5 - right sided round nodular MGT associated with right #5 - right HL weight bearing lameness - h/o right HL paw pad lesion on digit #2 BAR H EENT: no nasal or ocular discharge noted; 2/4 dental tartar H/L: eupneic PLN: WNL ABD: relaxed U/G: FS; mammary glands as described MSI: Ambulatory x 4, normal hair coat; right HL weight bearing lameness; no cranial drawer appreciated in stifles; R HL digit pad #2 lesion healing and small CNS: Mentation quiet - no signs of neurologic abnormalities A) Bilateral mammary glands masses r/o adenomas and/or adenocarcinomas right HL weight bearing lameness h/o small lesion on R HL digit pad #2- healing P) Dog sedation: Using 0.7 ml dexmedetomidine at 500mcg/m2 (500mcg/ml) and 0.7 ml butorphanol at 0.4 mg/kg (10mg/ml) IM Reversed with Antisedan-0.7 ml IM Chest/Hip/Stifle Rads: Chest clear Hips- NSF Right distal femur appears to have small lytic lesions r/o infiltrative disease vs artifact vs other Right HL Paw rad- no visible FB recommend second opinion on right stifle rads pending CBC/CHEM/T4

10/22/2025

Blood Results: Hct 38.9 % (low normal 41%) mild non-regenerative anemia) ALT elevated - 313 U/L (N high 121) r/o secondary to inflammation vs infiltrative disease vs other

Upon intake, dog was social and seeking attention from staff. Dog allowed staff to scan for MC, collar, and leash. She solicited play and allowed staff to brush her coat.