C09979471 / invoice 10000

03-03-2026 3:33:43pm
Presenting problem: No urine in 36hrs. Also not himself

History:

Less active than usual, decreased playfulness
No urination for 36 hours, defecated (small) last night
O is sure not eaten anything abnormal - been VERY careful re what is around him now
Current meds: clomav - increased around 10 days ago per behaviour vet, started after the last exlap. Also on gabapentin 50mg PO BID - didn't get morning dose for either
Current diet = on a hydrolysed diet trial - hills z/d wet and dry
Reluctant to allow bladder palpation - this had been noted by behaviour vet previously and they had wanted a UA done - but O has not been able to catch anything
Physical Examination:

QAR, clingy/nervous
Chest HR: 160
Abdominal palp: complaining with palpation - though historically has done this as well in the past without any urinary issues. Bladder palpable - medium size but not turgid.
BCS 5/9
Assessment:

Possible urinary obstruction (early stage) or retention from meds? Clomipramine can cause urinary retention, though has already been on this for quite a while so unusual to start having issues now?
Plan:

Hospitalisation for monitoring - give meds here and see if will urinate on own.
If not passing urine, we may consider GA and manual expression/unblock if obstructed. Xrays can be considered as well due to previous hx of FB ingestion.
Est $500 if just staying in and UA, but could increase to $3000 if requiring hosp/unblocking/imaging +/- surgery.
Treatment:

Admit to hosp
100mg gabapentin PO (pill popper + water chaser), and 0.3ml buprenorphine IM
Urinated in litter tray (beads) during hospital stay - UA done by AB.