C09974119 / invoice 10000

Reason: In-House Urine Dipstick/USG ResultsAppointment Notes: + vetnostics urine attached EDReport:                               URINE EXAMINATION    Specimen              Void    CHEMISTRY                     MICROSCOPY    CULTURE Heavy growth (>10^8 CFU/L)    Org 1:  Proteus mirabilis    SUSCEPTIBILITY    Ampi/Amoxycillin  S                 Cefovecin         S    Cephalexin        S                 Enrofloxacin      S    Doxycycline       R                 Sulpha/Trimeth    S    Marbofloxacin     S                 Clavulan/Amox     S    Final reportClient Communication: Spoke to Kaylin over the phone:Subjective: - See previous- Vomiting a few times today; first time since last Friday (no further vomits at time of call- Did eat a pig's ear this AM; not keen on peanut butter which Kaylin uses to give the medications; however managed to get in all of her evening medications- Also not keen on her kibble which is very unusual for her- No further blood in urine, though still pollakiuria noted- Has not defecated since yesterday morning; not straining to defecate howeverAssessment: - Vomiting: ddx primary GIT disease (gastritis, gastric ulceration, infectious, neoplasia, auto-immune), other systemic disease (kidney, liver, endocrine, neoplasia, other)- Generalised marked OA- Pollakuria, haematuria, proteinuria: confirmed UTI: upper vs lower, kidney disease (AKI vs CKD), urolithiasis, neoplasia- InappetanceClient Communication: 1. To try bland food- white rice, chicken mince and see if Phoenix would be more keen to eat (apparently doesn't respond well to white chicken meat)2. Continue with pain medications, Cerenia, Omeprazole, antibiotics (hopefully easier if eating above food)3. Start Ondansetron 16mg BID4. To address UTI, extend AB course from 7 to 12 days in total, drop urine sample off for repeat C&S on Friday (Day 7 of AB course)5. Will f/u tomorrow, then again on WednesdayDiscussed euthanasia if not improving over the next 48 hrs. Serious concerns of systemic disease, and likely to continue to deteriorate of not targeting treatment/intensive treatment.    Vital Signs