[Spay/Neuter Waiver – Age] 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.

DVM Intake Exam Estimated age: 12 Microchip noted on Intake? neg History : O surrender/ stray Subjective: QARH, non-ambulatory Observed Behavior – Easy to handle Evidence of Cruelty seen -n Evidence of Trauma seen -n Objective T = P = 120 R = eup BCS= 4/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: mod dental dz PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: Prominent vulva- no discharge. No spay scar seen. No MGT’s MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate. Ataxic pelvic limbs. No CP LRL. Decreased CP RRL. Rectal: Assessment: Neurologic dz. Geriatric. Prognosis: Poor Plan: Routine intake. Monitor. Consider EHR if no rescue. BW tomorrow. SURGERY: Permanent waiver due to neurologic dz.

S/O: QAR. Rests quietly in cage throughout most of day, becomes excited when other dogs in room. Excellent appetite EENT: Nuclear sclerosis, no ocular or nasal discharge HL: No coughing or sneezing INTEG: Unkempt MS: Difficulty walking but able to stand up A: Geriatric, neurologic disease suspected on intake, possible arthritis/joint disease. Blood work shows slightly elevated monocytes and globulins, all other results WNL, not significant P: Rec rimadyl 50mg PO q12 x 5 days. Poor long term prognosis

Progress exam History: Intake 11/17-ataxia and decreased/absent CPs. 11/18: Blood work shows slightly elevated monocytes and globulins, all other results WNL, not significant Started on rimadyl Subjective: QARH, non-ambulatory. No c/s/v/d. Good appetite. Able to walk with help of sling. Objective P = wnl R = wnl BCS= 4/9 EENT: Eyes clear with nuclear sclerosis ou, ears clean, no nasal or ocular discharge noted Oral Exam: Moderate dental disease PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: FI, no vulvar d/c, no MGTs MSI: Ambulatory x 4 with difficulty standing and walking-needs sling for longer walks, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate. Ataxic pelvic limbs. No CP LHL. Decreased CP RHL. Crepitus and pain in left hip extension, seems comfortable with right hop extension and stifles bilaterally Assessment: Ataxia r/o IVDD vs other spinal condition vs OA vs other Absent CP LHL Decreased CP RHL Geriatric Dental disease Prognosis: Poor Plan: Continue rimadyl until 11/22-consider extending Rec neurology consultation Recheck daily

Progress exam History: Intake 11/17-ataxia and decreased/absent CPs. 11/18: Blood work shows slightly elevated monocytes and globulins, all other results WNL, not significant Started on rimadyl Subjective: QAR, able to stand up on her own with some struggle and able to walk with a sling. No c/s/v/d. Good appetite. Seems to be resting comfortably in cage. Objective EENT: Eyes clear with nuclear sclerosis ou, no nasal or ocular discharge noted H/L: eupneic MSI: Ambulatory x 4 with difficulty standing and walking-needs sling for longer walks, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate. Ataxic pelvic limbs. Assessment: Ataxia r/o IVDD vs other spinal condition vs OA vs other Absent CP LHL Decreased CP RHL Geriatric Dental disease Prognosis: Poor Plan: Continue rimadyl until 11/22-consider extending Rec neurology consultation Recheck daily

Progress exam History: Intake 11/17-ataxia and decreased/absent CPs. 11/18: Blood work shows slightly elevated monocytes and globulins, all other results WNL, not significant Started on rimadyl Subjective: QAR. No c/s/v/d. Good appetite. Seems to be resting comfortably in cage. Objective EENT: Eyes clear with nuclear sclerosis ou, no nasal or ocular discharge noted H/L: eupneic MSI: Ambulatory x 4 with difficulty standing and walking-needs sling for longer walks, skin free of parasites CNS: Mentation appropriate. Ataxic pelvic limbs. Assessment: Ataxia r/o IVDD vs other spinal condition vs OA vs other Absent CP LHL Decreased CP RHL Geriatric Dental disease Prognosis: Poor Plan: Continue rimadyl until 11/22-consider extending Rec neurology consultation Recheck daily

Anastasia was very lethargic during intake and had difficulty walking. She was brought back to medical and no handling was done.