C09981847 / invoice 10000

Reason: Unwell, Blood In UrineAppointment Notes: yesterday spotted only able to come after 7pm todayVerified: NoHISTORYPresenting for: Male cat presented for recurrent urinary issues with haematuria that has been ongoing for approximately one year.Historical Conditions:- Chronic stress-related urinary issues with recurrent episodes over the past year- Previous episodes of haematuria and urinary inflammation- History of stress and anxiety affecting urinary healthDrinking/Urination:- Haematuria (blood in urine) noted today- Recurrent urinary issues with inflammationCurrent Meds:- Feliway previously used but patient recently developed aversion to it- Previously tried compounded gabapentin in chicken flavour capsules but difficult to administer due to patient stress and avoidance behaviourLifestyle Risk Factors:- Recently transitioned from indoor-only to outdoor access in past couple of weeks to reduce stress- Lives in side yard area when outdoors, doesn't roam to street- Historically indoor cat for many years prior to recent outdoor accessOther:- Patient becomes very stressed with medication administration and will hide when owners approach- Difficulty medicating has led to increased stress cycles- Patient exhibits avoidance behaviour, particularly hiding from female owner when medication time approaches- Owners delayed visit to avoid emergency situation but wanted to address before condition worsenedEXAMMentation: BARBehavioural: Active during examination. Patient required restraint for examination and treatment administration.Abdominal: Bladder palpably empty with no obstruction detected. Moderate amount of faeces palpable in colon.Rectal: Bladder inflammation detected on palpation. Blood noted to be present, indicating significant bladder inflammation.ASSESSMENTFeline idiopathic cystitis - Stress-related urinary inflammation with haematuria. Recurrent episodes over past year with no urinary obstruction present. Patient eating and drinking normally with no systemic signs.PLANMedications/Treatments:- Anti-inflammatory injection administered today - duration 3 days- Opioid pain medication injection administered - duration 5 hours  - Long-acting antibiotic injection administered to cover bacterial component- Plan to return weekly for repeat injections due to difficulty with oral medication administration at home- No home medications required due to administration difficulties and stress responseAdditional Discussion:- Discussed that urinary diet would be ideal for ongoing management but patient won't accept urinary prescription food- Treatment plan designed to avoid home medication administration to prevent stress cycles- 3-day recovery period expected with current injectable treatment protocol- If no improvement after 3 days, urine sample collection may be necessary for further diagnosticsClient Comms:- Explained stress-related nature of condition and treatment approach- Discussed weekly injection protocol as alternative to home medication- Advised to monitor for improvement over next 2-3 days- Return if condition worsens or no improvement seen    Vital Signs    Weight: 5.36;