C09984129 / invoice 40000

Report To:   VET HQ   389 New South Head Rd   DOUBLE BAY 2028Patient:   Name: TIMMINS, BILLY   389 NEW SOUTH HEAD RD   DOUBLE BAY 2028   Phone:   DOB: N/A   Age: 6 years   Sex: Male   Species: CanineRequest Details:   Lab Ref: 26-15914168   Your Ref: V641955   Collection: 27/02/26   00:00   Ref. by VET HQ DOUBLE BAYTests requested:   Final report.  Thank you for your referral.Clin notes:   Species: Canine,cavoodle,6y2m,MNReport:                            ACTH STIMULATION TEST   TIME (Hours)    CORTISOL (nmol/L)   0                    37  (30-100)   1.0                  79                              VETNOSTICS COMMENT.    I note that your hospital is using trilostane SID by preference. My   experience is that the dogs very rarely have good 24h on SID dosing of   trilostane. This dog is close to the recommended range at the time of   peak trilostane effect (30 -65 nmol/L at 1h) but will not be as well   controlled for the rest of the day. It is also notable that the dog is   particularly drinking a lot at night. Consider a dose change from 40mg   SID to at least 25mg BID - this said, 30mg BID is likely to be more   convenient to dose and likely to be a reasonable option for this dog as   long as they can commit to a follow up test two weeks later. As for all   treated hyperA dogs ensure the owner has Cortate at home in case needed.   Feel free to call if you want to discuss this case.   Jody Braddock   Veterinary Medical Consultant.  Vetnostics North Ryde NATA Accreditation Number: 14599.  Results apply to the sample as received.  Measurement of uncertainty (MU) may be applicable when interpreting  borderline changes in results.  Please refer to www.vetnostics.com.au for MU information.Assessment: Perfect reposne Telephone Call: --- 04/03/2026 08:25:21 GMG:Left message for ownewr    Vital Signs    

Appointment Notes: ccchat and admit for acthc stim test . GG9AM  1PMAdmit by: Nurse -    MS                  Vet - GGBrought in by:  Current Dose of Trilostane:  40 MG VETORYL Once or twice daily:  sidtime given this morning 9am How long have you been giving the current dose for: Vetoryl or compounded medication: If compunded where from: Given with food?:What food is fed:  (fat content if known):Behaviour at home: normal Appetite:  FIONE Water intake:  15% LESS AND FILLING WATER BOWL A LOT Is there daily changes in thirst ie. in the morning or evening   evening moreUrination Pattern: THE ASAME - Puippy matt close everything Will use puppy matt every night  Breathing issues: coughing panting wheezing normal How do you think your dog is feeling: Are you happy with progress: Amount Synacten given: Time of test:    Vital Signs    Weight: 9.1;       

Reason: GG - Recheck Health (TB)9% Somethign is different Pd Hyperaroused at home No off lead Hysterical with anyon on staircaseVerified: NoHistory:Presenting for: Canine patient presented for recheck of hyperadrenal disease and behavioural issues. Owner reports some improvement in hyperarousal behaviour when walking outside.Historical Conditions: - Previously diagnosed with hyperadrenal disease- Severe behavioural issues including hyperarousal, excessive drinking, and reactivity to neighboursDiet: Normal appetiteDrinking/Urination: - Excessive drinking, particularly at night- Owner reports patient had to be let out at night for a massive drink- Owner's partner had been removing water overnight (between midnight and 5-6am) but was advised against thisV/D/C/S: None reportedCurrent Meds: - Betavet 30mg SID in AMLifestyle Risk Factors:- Lives in apartment with courtyard- Common property areas trigger reactivity- Household includes teenager with ADHDOther:- Owner reports 5-7% improvement in behaviour, possibly up to 9%- Still hyper-aroused at home- Extremely reactive to neighbours using common staircase- Not suitable for off-lead walking- Morning routine includes long walk followed by daytime nap- Becomes more agitated in afternoon and eveningExamination:Mentation: AlertBehavioural: Hyperarousal noted, particularly reactive to people in common areas of property. Owner reports patient is less frenetic when walking outside compared to previous visit.Diagnostics: ACTH stimulation test scheduled for follow-upAssessment:Hyperadrenal disease - Partially responsive to current medication doseBehavioural issues - Slight improvement noted with current treatment but still significant hyperarousal, particularly in afternoon/evening and in response to triggers in common property areasPlan:Diagnostics:- ACTH stimulation test scheduled for 27/02 at 12:15pm, to be performed 4 hours after morning medication administrationChanges to Existing Meds/Tx:- Increase VETORYL  from 30mg SID to 40mg SID in AM- Continue once daily dosing rather than BID as improvement has been noted but is insufficientAdditional Discussion:- Discussed that approximately 20% of dogs require BID dosing of medication- Advised that if patient shows any signs of vomiting, diarrhoea, or incoordination to administer emergency medication previously provided and contact clinic immediately- Noted that if significant improvement is seen with increased dose, patient may be able to return to clinic sooner (Monday/Tuesday)Client Comms:- see if daily change as may change to bid dosing Await response    Vital Signs    Weight: 9.2;