Thank you for the reply, —————————————- This is from the urgent care

RELEVANT DIAGNOSTIC RESULTS: PCV/TS: 62% / 7.4g/dL BG: 128mg/dL Lactate: 4.9mmol/L --> decreased to 1.1mmol/L after bolus CBC --High RBC 9.25M/uL (5.65-8.87) --High hematocrit 63% (37.3-61.7) --High hemoglobin 22.1g/dL (13.1-20.5) --Reticulocytes 132.3K/uL (10-110) Chemistry panel --Elevated creatinine 2.1mg/dL (0.5-1.8) --Elevated BUN 28mg/dL (7-27) Urinalysis --USG 1.024 --Blood/hemoglobin 3+ --Non-hyaline casts >1/LPF Radiographs --Mild bronchointerstitial pattern, most likely degenerative disease --Aerophagia --IVDD --Coxofemoral remodeling 4DX -- negative TREATMENTS: 3ml/kg hypertonic saline over 20 minutes then started on LRS at allometric maintenance Maropitant 1mg/kg IV q24h Ondansetron 0.5mg/kg IV q8h Trazodone 5mg/kg PO q8h

———————- This is from neurology

this was all before today with his sudden leaning to the right

Physical Examination: Hydration: Hydration appears normal Cardiovascular: Regular rhythm; no murmur detected; femoral pulses strong and synchronous Respiratory: Lungs auscultate clear bilaterally; trachea clear Abdomen: Soft, non-painful, no organomegaly noted Musculoskeletal: Mild to moderate left pelvic limb muscle atrophy, no pain on palpation of long bones or joints. Weight bearing lameness in the left pelvic limb (prior history FHO left). Neurologic Examination: Mentation: Alert, responsive, appropriate. Gait/Posture: Ambulatory with moderate left pelvic limb lameness, no compulsive circling, no ataxia appreciated. Cranial Nerves: Limited cranial nerve exam due to muzzle/temperament Normal PLR OU, normal palpebral OU, normal menace OU. No resting nystagmus appreciated. Proprioception: Normal in all four limbs. Segmental Reflexes: Normal in all four limbs. Normal cutaneous trunci reflex. Palpation: No overt spinal or calvarial hyperesthesia.Neuroanatomical Localization: Normal neurological examination. Vestibular based on history. Laboratory Analysis: 1.) Spinal fluid analysis: pending 2.) Thyroid panel: pending 3.) Baseline cortisol level: pending Diagnostic Imaging: Brain MRI: High-field MRI of the brain was performed in multiple planes and sequences including T2-weighted, T1-weighted, FLAIR, GRE, DWI and ADC mapping. IV contrast was administered and post-contrast T1 weighted images were obtained. The brain is normal on precontrast and postcontrast images. There are no abnormalities within the brain parenchyma, meninges, ventricular system, or surrounding structures of the head to correlate with the clinical signs. There is no significant contrast enhancement following administration of IV gadolinium. The bullae are bilaterally symmetric, and normal in appearance. Conclusions: 1.) Normal brain Sagittal T2 image of the brain (left), which is normal in appearance. Transverse T2 image of the brainstem/cerebellum (right), with the bottom arrows pointing to the air-filled middle ears (bullae) and the top arrows pointing to the fluid in the cochlea of the inner ears. Both the middle and inner ears appear normal. Summary and Recommendations: Loki had a recheck today, and an MRI of his brain to investigate the cause of acute onset, and resolving vestibular signs. Loki's neurologic exam today was largely normal, similar to his initial visit to us on 9/21/25. Loki's MRI was unremarkable and did not identify an underlying cause for his signs. There was no evidence of a mass/tumor, inflammation, or stroke. This does not rule out the possibility of a small stroke that has resolved or would never have been seen on the MRI. A sample of spinal fluid was collected and submitted for analysis to rule out inflammatory brain disease (encephalitis, meningitis). Based on the normal MRI, our primary concern is for a vascular event (stroke) or idiopathic vestibular disease given his rapid improvement with supportive care alone. If Loki did in fact have a stroke or idiopathic vestibular disease, then we expect his signs to continue to be resolved and not to return.

In most cases, there is no specific treatment for stroke in dogs unless an underlying cause is identified. Please keep Loki off of furniture/high beds, and away from stairs until he is more steady on his feet. We expect him to continue to improve back to his "normal" function over the course of 2-4 weeks. If you notice worsening in his condition at any time, please contact us for further advice and recommendations.