WINNIE – 10475

DVM Intake Exam Estimated age: ~3-4 years Microchip noted on Intake? negative History : stray Subjective: BARH Observed Behavior – very sweet but quiet, tense, and nervous. 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 5/9 EENT: Eyes clear, ears clean, no nasal discharge noted Oral Exam: adult dentition with mild dental tartar, no oral lesions noted PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: FI, no MGTs, no vulvar d/c MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: mentation appropriate – no signs of neurologic abnormalities Assessment: Apparently healthy Plan: Continue to monitor while at BACC Prognosis: Excellent SURGERY: ok to schedule for surgery

Progress exam-noted by staff to be having tremors History : stray intake 10/22. Had prolonged bleeding after microchip but otherwise wnl Subjective: BARH. No c/s/v/d. Has 5-10s focal tremors of face about once a minute. Objective BCS 5/9 EENT: Eyes clear, ears clean, no nasal discharge noted H/L: eupneic U/G: FI, no MGTs, no vulvar d/c MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: mentation appropriate most of the time but has ~5-10s episodes with star gazing and focal tremors of face and ears Assessment: Apparently healthy Tremoring r/o small dog anxiety vs focal seizures vs other Prolonged bleeding after microchip on intake Plan: Continue to monitor while at BACC CBC/Chem tomorrow Prognosis: Good depending on test results

Young adult Yorkie, noted to have focal head tremors and possible star gazing episodes; blood work available for review: CBC: slightly low hct (36%), mild neutrophilia (15.23 K/uL), moderate to severe monocytosis (3.12 K/uL) Chemistry: low creat (0.3), low normal chloride (108) S/O -QAR, mentation seems slightly abnormal, decreased interactions, “star gazing” -appears visual but menace intermittent -mm pk, sl tacky; CRT <2 sec -eupnic -ambulatory x 4 with no ataxia noted but occasionally will lose balance when standing -mild trembling in cage, appears as if it could be behavioral but also has possible mild focal head tremors intermittently -decreased to absent withdrawal x 4, proprioception intermittently delayed on hind limbs A 1. Abnormal mentation, star gazing-could be behavioral due to breed but suspect underlying neurologic condition 2. Low normal hct 3. Monocytosis-concern for chronic, ongoing process 4. Neutrophilia-mild P Brought to medical for seizure watch and monitoring Recommend bile acids testing, +/- abdominal ultrasound and MRI prognosis: open, concern for underlying neurologic condition such as liver shunt, meningitis vs other

Based on record review, this dog should be waived from spay at ACC. Ideally the dog should have further diagnostics outside of the shelter for its neurologic condition to assess whether or when the spay should be done in the future. 0587

[Spay/Neuter Waiver – Medical Condition] Your newly adopted pet has been diagnosed with a possible underlying neurological condition and the staff veterinarians are issuing a (temporary waiver from the spay/neuter requirements of the City of NY. Follow up care at your regular veterinarian is recommended to ensure continued treatment. Your veterinarian will advise you if surgical sterilization is appropriate.