C09984023 / invoice 20000

Appointment Notes: Overdue remindersAdmit by: Nurse - smt                     Vet -Brought in by: tammiCurrent Dose of Trilostane: vetoryl 50 mgOnce or twice daily: twicetime given this morning 7AMHow long have you been giving the current dose for: 2 weeks 1 dayVetoryl or compounded medication: vetorylIf compunded where from: Given with food?: yesWhat food is fed: boiled chicken breast, kibble throughout the day  (fat content if known):Behaviour at home: normal Appetite: sameWater intake: sameIs there daily changes in thirst ie. in the morning or evening sameUrination Pattern: sameBreathing issues: noneHow do you think your dog is feeling: sameAre you happy with progress:  yesAmount Synacten given: 0.1mlTime of test: 11:06AMMeds Collected (SW)Lab Ref: 26-15914166   Your Ref: 641919   Collection: 27/02/26   00:00   Ref. by VET HQ DOUBLE BAYTests requested:   Final report.  Thank you for your referral.Clin notes:   Species: Canine,maltese,8yr 7mn,fn.Report:                            ACTH STIMULATION TEST   TIME (Hours)    CORTISOL (nmol/L)   0                    49  (30-100)   1.0                  55                              VETNOSTICS COMMENT.    This is a bit confusing as this dog earlier this month was reported to   be on 40mg BID trilostane with poor control and now is reported to be on   15mg BID trilostane and has excellent control. Maybe an incorrect   reporting of this dose? (previous submissions show doses of 20mg and 30mg   BID). **** CORRECTION - dose noted on file by admission nurse was 15mg - should have been 50 mg ********Anyway whatever this dose / formulation is - maintain this and   recheck in 3 months or sooner if there are earlier concerns.   Jody Braddock   Veterinary Medical Consultant.Plan: 1. Continue with vetory 30 + vetory1 10 x 2 bid until next test in 3 mths 2. If ACTH is good at this time, change to compounded 50mg capsules3. Repeat test 2 weeks post change to generic ( if risk adverse)  or if clinically well, retest 3mth after change to compounded meds    Vital Signs    Weight: 3.3;       

ST    Vital Signs