DVM Intake Exam Estimated age: 10-12 years Microchip noted on Intake? negative History : stray Subjective: BARH Observed Behavior – very sweet but tense, nervous, and whale eyes. Easily handleable. Did well for all medical handling and procedures Evidence of Cruelty seen – no Evidence of Trauma seen – no Objective P = wnl R = eupneic BCS 6/9 EENT: Eyes clear with nuclear sclerosis ou, ears clean with hair in canals, purulent nasal discharge noted Oral Exam: adult dentition with moderate dental disease and oligodontia, no oral lesions noted PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, distended and very hard, unable to deeply palpate U/G: FI, no MGTs, no vulvar d/c, edematous vulva MSI: Ambulatory x 4, skin free of parasites, no masses noted, thinning hair coat with comedones CNS: mentation appropriate – no signs of neurologic abnormalities Assessment: CIRDC Geriatric Distended abdomen r/o Cushing’s vs other endocrine disorder vs other Dental disease Nuclear sclerosis ou Plan: Continue to monitor while at BACC CBC/Chem/T4 tomorrow Rec workup for endocrine disease with placement Start doxycycline 10mg/kg PO SID x10d Recheck day 5, 10 Move to iso Prognosis: Good to fair SURGERY: permanent waiver from surgery due to age

[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.

CBC shows mild non-regenerative anemia Chemistry shows mild elevation in BUN, globulins and cholesterol T4 low end of normal A: R/O anemia of chronic disease, possible hypothroidism P: Continue with current treatment and monitoring plan. Rec freeT4 and canine TSH with placement to confirm hypothyroisism Fair prognosis

Day 5 of doxy, recheck CIRDC S/O: Q/BAR. Attention seeking. EENT: Nuclear sclerosis, mild mucoid nasal discharge HL: No coughing or sneezing A: CIRDC resolving well, R/O hypothyroid P: Continue with current treatment and monitoring plan.