C09972301 / invoice 10000

Spoke to April on phone, had a good month but signs of UTI have returned including pollakiuria and strong smell.
Considering timing of phone call okay to dispense antibiotics - wanted to dispense tribrissen (TMS) but none on shelf so dispensed 150mg enrofloxacin SID for 7 days then C&S 2 days after finishing. 
O elected to pay in advance for cysto and urinalysis. 

Recommended repeat consultation with Darren at MVSC - is there something we can do to control the pH? 

O walked in with no appt for 4th Synovan so not with vet

Gave 0.2ml SC in waiting room. April was a good girl.

Suggested booking in with vet in the next few weeks to discuss where we go from here as last vet appt was missed

LU spoke with Val over the phone. 

Urine results: 
USG 1.035
Cloudy
RCC x 106/L 60 * 0 - 0 |-----|*
pH 8
No growth day 2

Still itching at paws and vulva poor girl. Using dilute iodine on these areas - appears to relieve the risk of self trauma to these areas. No change to urination on meloxicam no adverse effect. 

Plan: Long discussion with Val re plans, considering history of resistant bacterial infections suspected intramural and no change to urinary behavior after meloxicam okay to trial trimethoprim sulfa course as usually if functional will respond clinically within a day or two. In meantime, LU to send update history to Darren at MVSC for advise especially on whether repeat visit with specialist is warranted.