DVM Intake Exam Estimated age: ~12yrs Microchip noted on Intake? No History : Brought in by NYPD Subjective: QAR. ~8% dehydration Observed Behavior – Difficult to handle, will head turn and snap Evidence of Cruelty seen – no Evidence of Trauma seen – no Objective P = WNL R = WNL BCS 1/9 EENT: nuclear sclerosis, ears clean, no nasal discharge noted Oral Exam: Mild dental tartar, pink/pigmented mm PLN: No enlargements noted H/L: Grade 4/6 heart murmur, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: Female MSI: Ambulatory x 4 but marked weakness and pain in hind end, no palpable fractures, no obvious injury, skin free of parasites, no masses noted, unkempt hair coat, large clumps of hair falling out CNS: mentation appropriate – no signs of neurologic abnormalities Assessment: Geriatric, dehydrated, emaciated, hind end lameness – R/O arthritis vs other, heart murmur Plan: Administered hydromorphone 0.3ml IM, LRS 200ml SQ. Blood work pending. Continue to monitor while at BACC — ~10minutes after hydro administration, dog vomited large pile of what appears to be deli meats Prognosis: Guarded SURGERY: Permanent waiver due to age Addendum: Blood work results showed no significant findings – Adding rimadyl 25mg PO q12 x 5 days

No significant findings on blood work CBC shows very mild lymphopenia Chemistry shows mild decrease in amylase

Monitor condition – geriatric underlying S/O: QAR. No skin tent. Eating meals well but not eating meatball with rimadyl. EENT: Nuclear sclerosis, no ocular or nasal discharge, ears wnl, did not allow oral exam HL: HR 120, normal RR/RE, grade 2/6 murmur (significantly lower than on intake exam) ABD: Soft, non tender INTEG: Unkempt MS: Weakly ambulatory x 4, stiff in hind end, no palpable or visible injuries UG: Spay scar palpated A: Geriatric, emaciated, intermittent/transient heart murmur, hind end lameness (improved since intake)- R/O osteoarthritis vs other; blood work on intake WNL P: Switching from oral rimadyl to injectable – 1ml SQ q24 x 3 days starting today (did not take morning rimadyl). Prognosis upgraded from guarded to poor

Monitor condition S/O: BARH. Alternates between resting quietly and comfortably in cage and standing in cage barking throughout the day. Eating with excellent appetite. Normal stool. Allows handling much more so than on intake exam but still resists oral exam and tries to snap when near face/head EENT: Mild dental tartar, nuclear sclerosis, no ocular or nasal discharge, ears wnl HL: Grade 2/6 heart murmur, lungs auscultate clear, no coughing or sneezing ABD: Tense, no masses palpated INTEG: Unkempt MS: Ambulatory x 4, slightly stiff in hind end but significant improvement UG: Female A: Geriatric, emaciated, low grade heart murmur, limb/joint pain improved P: Continue with current treatment and monitoring plan. Poor long term prognosis