C09978474 / invoice 20000

SHIFT CHANGE 2100-0700VET: Dr Madeleine HearndenASSESSMENT:Vitals as per SmartflowEating well Urine clear yellow, UOP 0.7-1.3 ml/kg/hrTREATMENT: Changes to treatment plan - Nil CLIENT COMMUNICATION:Nil communication required overnightPlan for next day: Internal transfer--- 3/03/2026 8:00:21 AM MH5: Text sent ------- Good morning Lina, just sending you an update to let you know your darling Mario has been stable overnight. They have been comfortable, sleeping well, eating with gusto, though a little anxious. Mario will be on handed over to TVH Bellerive surgical team shortly, where they’ll be reassessed and you will be contacted. If you have any further questions about Mario's stay with us, please feel free to reach out to the clinic on 1300 302 912. All the best with Mario's ongoing recovery, he is an absolute sweetheart. Take care, Dr Maddi @ AES Hobart-----------------TREATMENT SUMMARYMario  has been treated/monitored at Animal Emergency Service for post cystoscope + cystotomy Overnight he has been stable and comfortable and eating with clear urine. Please refer to *Smart Flow - Flowsheet* pdf for detailed clinical exam records and hospital notes.Treatments given & when next due are as follows:* IV fluids at 57ml/hr Hartmanns  * Fentanyl  1 ug/kg/hr IV CRI ongoing * Cefazolin 20mg/kg - last given at 0100* Gabapentin 300mg PO q8-12hr - last given 0600, next due 1400/PRN * Trazodone 100mg PO q8-12hr - last given 0600, next due 1400/PRN * Omeprazole 1mg/kg - last given 0650If you have any queries relating to this case, please call 1300 302 912    Vital Signs    

REFERRING CLINIC: TVHAES VET: LNREASON FOR REFERRAL: Post cystoscope + cytotomyRELEVANT HISTORY ONLY:Post cystoscope + cystotomyDIAGNOSTIC SUMMARY:NoneMEDICATION PLAN - WHEN LAST GIVEN & WHEN DUE NEXT:* Fentanyl CRI @ 2ug/kg/hr* Cefazolin 20mg/kg IV * Omeprazole 1mg/kgEXAMINATION:No concerns See smartflowPROBLEM LIST:DysuriaASSESSMENT: Stable comfortablePLAN: TVH-IClient communication and account update: YMode of transfer: TVH-ICOMMS:Texted owner    Vital Signs    

History:Presenting Concerns: Stranguria of 2 days duration.  The owner reports that since Saturday morning, Mario has been straining to urinate, passing only small amounts of urine slowly. His appetite is reportedly decreased, as he did not eat his breakfast this morning, though he did eat last night.  No vomiting has been observed.Polydipsia was also reported. There is no history of previous urinary issues.Examination:Mentation: Bright, Alert, and Responsive  Body Condition Score: 5/9  Weight:  24.1kgHeart Rate:  100Respiratory Rate: panting Mucous Membranes: pink  Capillary Refill Time: 1-2 seconds  Pulses: Strong and synchronous femoral pulses  Temperature:  38.9  Cardiovascular: Normal cardiac rate and rhythm, no murmur or arrhythmia detected  Respiratory: Tachypnoea with normal respiratory effort  Abdomen: Painful at caudal abdominal palpation, bladder does not feel distendedMusculoskeletal: Able to right, rise and ambulate without lameness, full exam not performedEyes/Ears/Nose/Throat: Moist oral mucous membranes, no ptyalismNeurological: Mentation and gait appropriate  Lymph Nodes: Submandibular, prescapular and popliteal lymph nodes within normal limits  Integument: Normal skin turgorUrogenital: Stranguria in consult, dribbling small amounts of dark yellow urine.  Rectal: Prostate palpably enlarged, not painful. Soft faeces in rectum.Diagnostics:-   Sedation with 4 ug/kg dexmedetomidine and 0.2 mg/kg methadone intravenously.-   Abdominal radiograph: Single LL. Revealed small calculi within the urinary bladder. Not visible urethral calculus, but this is suspected. Large amount of overlying fecal material.-   Urinalysis (via ultrasound guided cystocentesis): The bladder was approximately 2.5-3 cm in diameter and contained a large amount of sediment and multiple calculi.. The sample was unrewarding, which is thought to be due to sampling the supernatant urine rather than the sediment.Assessment:Problem list1.  Stranguria/dysuria2.  Cystic and suspected urethral calculi (urolithiasis)3.  Prostatomegaly4.  PolydipsiaDifferential Diagnoses1.  Urinary tract infection2.  Urethral obstruction secondary to calculi3.  Benign prostatic hyperplasiaPlan:The finding of bladder stones and suspected partial urethral obstruction secondary to urethral calculi was discussed with owner. The case was also discussed with Dr Jo Stumm from Tasmania Animal Hospital, and their recommendation for cystoscopic stone retrieval was relayed to the owner. The owner expressed interest in proceeding with this option. An estimate of $3,500-$4,000 was provided for the surgical procedure, with the understanding that ongoing hospitalisation would incur further costs. The owner is aware that Mario will need to remain in hospital overnight. An in-person consultation between the owner and the surgeon has been scheduled for 3 p.m. today to discuss the procedure and ongoing care in more detail.    Vital Signs    Weight: 24.15;