C09979090 / invoice 10000

Reviewer

Species:CANINE

Breed:Miniature Pinscher

Age (years):9

Diagnosis or signs:Consultation

Consult notes

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<p>Subjective: <br>Pet's signalment: Pepe, 9.5 years old, Min pin, male<br>History: <br>- Patient presents for a productive, gurgling cough.<br>- The cough is reported to be worse in the mornings and at night when the patient is recumbent.<br>- The patient and his canine housemate were boarded for three weeks in January 2026.<br>- Upon returning home (approx. January 30, 2026), the housemate developed a "goose-honking" cough, which resolved without treatment over two weeks.<br>- Pepe began showing clinical signs after the housemate recovered, and the signs have progressively worsened.<br>- A visit to a different veterinarian on February 27, 2026, noted an inflamed throat, but no medications were prescribed.<br>- The owner reports the patient is eating more slowly and has lost 400g since the vet visit last week.<br>- Patient has a history of a sensitive stomach and what the owner describes as "tracheitis" since puppyhood.<br>Diet: A prescription digestive kibble, sometimes softened with water.<br>HW/ flea + tick preventative: Not discussed.<br>Current Medications / supplements: None.<br>Any vaccine or medication reactions: None reported.<br>Recent blood test: Comprehensive bloodwork performed in December 2025 was reportedly within normal limits.<br><br>Objective: <br>Weight: 4.5 kg<br>Temperature: Not taken<br>HR: WNL<br>RR: WNL<br>BCS: 5 out of 9<br>FAS: Green<br>Hydration: Hydration appears normal<br>Eyes: no clouding, no debris, sclera is clear. Pupil sizes are symmetrical <br>Nasal: Patent and clear. No lesions or other abnormalities<br>Ears: No debris or erythema<br>Oral Cavity: healthy teeth and gums<br>Cardiovascular: no murmur or arrhythmia, strong pulses.<br>Respiratory: <br>- Lungs sounds are clear, no crackles or wheezes noted on auscultation.<br>- A MILD WHISTLE WAS NOTED ON RESPIRATION, SUGGESTING AIRWAY CONSTRICTION.<br>- POSITIVE TRACHEAL PINCH, ELICITING AN IMMEDIATE AND ABRUPT COUGH.<br>Abdomen: comfortable on palpation, no mass effect, no fluid wave<br>Musculoskeletal: Normal ambulation, Normal ROM<br>Integument: skin looks normal; hair coat in good condition. No ectoparasites. No masses found.<br>Lymph nodes: Lymph nodes are soft and small<br>Urogenital: External genitalia appears normal; bladder palpates normally<br>Neurologic: Normal mentation<br><br>Assessment: <br>Problem List:<br>- Productive cough<br>- Tracheal sensitivity<br>- Weight loss<br>- Slowing food intake<br>Differentials: The clinical signs are highly suspicious for infectious tracheobronchitis (kennel cough). Other differentials include allergic bronchitis or tracheal collapse, potentially with a secondary bacterial infection.<br><br>Plan: <br>Treatments: <br>- Initiate steam therapy at home by placing the patient in a steamy bathroom for 5-10 minutes daily to help loosen respiratory secretions.<br>- Recommend removing potential environmental irritants such as diffusers or candles.<br>- Advised to soften food with water to aid in comfortable swallowing.<br>Diagnostics Completed: <br>- Physical examination.<br>Prescriptions: <br>- Antibiotics prescribed for a 6-day course to address potential secondary bacterial infection. Dispensed as quarter-tablets to be given once daily.<br>Follow up:<br>- Re-evaluation is recommended if clinical signs do not improve or worsen.<br>- Chest radiographs would be the next recommended diagnostic step to further evaluate the trachea and lungs if the condition persists.<br>- Advised that the patient is likely contagious and should be isolated from other dogs.</p>
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Previous claim history (4)

Date	Claim #	Diagnosis
2026-02-26	C09960598	INFECTIOUS CANINE TRACHEOBRONCHITIS (KENNEL COUGH)
2025-12-04	C09581643	VACCINATIONS OR HEALTH CHECKS
2025-08-14	C9093615	LETHARGY - PRESENTING COMPLAINT
2024-12-21	C8108261	VACCINATIONS OR HEALTH CHECKS

Line items(lines with upstream diagnosis are skipped by the model)

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_antibiotics_-_doxycycline	27.01	2026-03-03	—
20000	tstarc_consultation-revisit	109.00	2026-03-03	—

UPM+

DG02375INFECTIOUS CANINE TRACHEOBRONCHITIS (KENNEL COUGH)DSTP_respiratory_tract_infection_-_kennel_cough

Variant (sleepy_king)

COUGHING - PRESENTING COMPLAINT

DSTP_clinical_signs_-_coughing

Conf: 0.460

Threshold: 0.40

Above: ✓

Correct?

Yes No

Reason (correct)