SMR Friends

. I appreciate everyone's interest in Tango. He has issues I hope they can resolve. He has banged his head a few times turning to the right. He is afflicted with very, very weak hind legs, and his head tilt is still obvious. I believe he will be on BP meds for the rest of his life. Anyway, here is part of the report. Unfortunately I cannot get the actual MRI in a post. Suffice to say they believe he had a vascular event.

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Client: Lori

Thank you for referring Tango, a male neutered Mixed breed that is 14 years & 5 months old. He was presented to our facility on April 17, 2024.

Chief Complaint:

4/17/2024: Chief Complaint - weakness in rear

Physical Exam :

4/17/2024: Physical Exam w/ Neuro Exam

- Subjective/Complaints: Eyes: Normal Ears: Normal Oro-Nasal: Normal

Heart: Normal, HR = pulses, hydration normal, pink mm, HR 90/min * Lungs: Normal, panting

Abdomen: Normal Urogenital: Normal Rectal Exam: Normal Musculoskeletal: Normal Integument: Normal Lymph Nodes: Normal * Neurologic: see Neuro Exam

*

Neurolocalization :

4/17/2024 - Location: Brain

Rule Outs:

4/17/2024 - Degenerative, anomaly, metabolic, neoplastic, infection, inflammation, toxin, parasite, vascular, trauma, disk

Laboratory :

4/17/2024: Blood gas/respiratory cassette - Vetstat - within normal limits 4/17/2024: Ionized calcium cassette - Vetstat - within normal limits

4/17/2024: Blood pressure - single - on doppler cuff #5 on left rear limb O 174, 170, 174, 174, 174, 174 4/17/2024: Culture - Urine - no growth

4/17/2024: Culture - Tissue/Fluid - no growth

4/17/2024: CSF Analysis - increased percentage of neutrophila without a pleocytosis.

Radiographic Procedures :

4/17/2024: Ultrasound

duodenum - within normal limits - Free Fluid: No Free Gas: No Urinary Bladder: empty *

Gall Bladder: full Liver: within normal limits Spleen: within normal limits Kidneys: right: 5.73 cm left: 5.32 cm

"Tango"

MRI:

4/17/2024 - Brain MRI - normal study, no contrast enhancement

Medications Dispensed or Prescribed :

Baytril Tabs 68mg, Give 1 tablet(s) by mouth once daily (every 24 hours) until finished. Antibiotic. Baytril Tabs 136mg, Give 1 tablet(s) by mouth once daily (every 24 hours) until finished. Antibiotic. Benazepril 10mg tablets, Give 1 tablet by mouth once daily (every 24 hours)

Meclizine 50mg, Give 1 tablet by mouth twice daily (every 12 hours)

Recommendations:

4/17/2024: Recommendations - Discussed therapeutic and diagnostic options with owner, from doing nothing to everything. Discussed risks associated with procedures including death 2 % of the time. Discussed possible protracted recovery with owner.

Diagnosis :

4/17/2024 Vestibular Disease

4/17/2024 Hepatopathy , elevated - alkaline phosphatase 4/17/2024 Hypertension

4/17/2024 Suspect vascular event

Neurological Exam :

4/17/2024: Neurological Examination

OBSERVATION: ----> Mental Status: Normal Posture: Right torticollis * Gait: Pacing

*

PALPATION:----> Muscular: Tone, atrophy: Normal Skeletal: Normal ..

KEY: 4=Clonus ; 3=Exaggerated ; 2=Normal ; 1=Diminished ; 0=Absent ..

POSTURAL REACTIONS:----> * Hopping: Left Front= 1 Right Front= 1 Left Rear= 1 Right Rear

= 1 Placing Tac: Left Front= 1 Right Front= 1 Left Rear= 0 Right Rear= 0 Placing Vis: Left Front = 1 Right Front = 1 Left Rear = 1 Right Rear = 1 Wheelbarrow: Normal Post Thrust: Not done Hemistand/Walk: Falls

CRANIAL NERVE REFLEXES:----> II-VII - Menace: Normal Pupil Size/Symmetry: Normal

PLR Stirn. Left eye: Normal PLR Stirn. Right Eye: Normal II Fundus: Normal

Ill, IV, VI Strabismus: Normal VIII-Ill, IV, VI Nystagmus: Abnormal Nystagmus Positional: DV to fast left occasional rotary Oculovestibular Response: Normal V Sensation Maxillary: Normal V Sensation Ophthalmic: Normal V Sensation Mandibular: Normal V Motor Mastication: Normal VII Facial Symmetry: Normal V-VII Palpebral: Normal IX, X Gag: Normal XII Tongue: Normal Eye Drop: Normal *

SEGMENTAL SPINAL REFLEXES:----> Biceps C6-C8: Normal ... Triyeps C7-T2: Normal Ext. Carpi Rad. C7-T2: Normal Flexion Fore C6-T2: Normal Lumbosacral

lntumescence: Normal Patella L4-L6: Normal Cranial Tibial L6-S1: Normal *

Peroneal Nerve: Normal Gastrocnemius L5-S1: Normal Flexion Hind L6-S1: Normal Perinea! S1-S2: Normal

Tibial Nerve: Normal

Babinski: Normal

URINARY FUNCTION:----> Evidence of voluntary micturation?: Normal Bladder distended?: Normal Ease of bladder expression?: Normal

SENSATION:----> Hyperesthesia: None Cutaneous Trunci: Normal Deep Pain: Normal Technician: Anna * Summary: Exam was conducted without owner present due to COVID-19 protocol. Exam results were discussed with owner.

Thank you again for this referral. This demonstration of your confidence is appreciated. If you have any questions about this or additional cases in the future, feel free to call.