C09972702 / invoice 10000

Was fine o'nt - usual behaviousr on owners bed - but this am sudden onset neuro Dz this am - staggery and vomitedEats well usually - a lot!On presentation 7.30am......Ht rate 200Bilateral nystagmusQuietMMs good - resps ok - but was doing some mouth breathingTxdrip - started 7.50pamlin 0.3mls - prevomax 0.3 mls both sc - Dex 0.6 mgs ivRun blood sincl t4 and crpHaematol is quite good - not anaemicBiochem - renal indices all good - creat low is due to hepatopathy - gluc not low - K+ is low @ 2.7 (<3.5) - Alt has gone up to mid 300s from mid 200s - AP is ok - GGT is sl up - 5 (<4) - T4 is 88 ...a bit high.... crp is only 1.4....Add K+ to the drip during the day....Request to Scan liver & abdo?? request to do to see there's no abdo mass etcGAVE FELIMAZOLE PILL AROUND 12 NOONScan abdo - needed some iv torb/acp - only a smidge - just too lively nowResult - gall bladder dilated with some early bile duct showing - no sludge - loss of normal hepatic architecture - too homogenous - suggests chronic hepatopathy - no lumps in abdo nor free frluid - kidneys/bladder look okay - spleen fine - gut not really imaging up....Rx Denamarin 1 sid x 1 month as liver supportCHR HEPATOPATHY MAY BE CAUSE of polyphagia...Ears - both dirty externally - cleaned them - ran in Vue - yeast there - Tx Dermotic bid x 6 to 10 daysScoped canals - lower canals are okay - but certainly ears could be related to the Vestibular - nystagmusBy midday nystagmus had essentially stopped and he is much happier cat....Try feeding

2.5mg - give 1 BID

TT4 37 (10 - 60 nmol/L)low CREAT- likley due to poor muscle mass, remainder kidney values WNLALP 56 (5 - 50 U/L) - prev 135GGT and ALT normalised cardiac proBNP normalPx:repeat TT4 q6 monthlyrepeat full bloods q12 monthlycontinue felimazole 2.5mg BID