C09984146 / invoice 20000

Convenia - dermatitis from IV cath last week - o applying neocort and using ecollarRecheck INI    Vital Signs    

--- 25/02/2026 15:31:53 SN:O called backClient Communication: Discussed results with Annette and discussion with Kath Briscoe. Is not fed jerky treats. Plan: Will start Telmarstin 1mg/kg PO SID Recheck in 1 month - UPC - BP - Bloods O does not think will go ahead with renal biopsy    Vital Signs    

Reason: Admit for Ultrasound Appointment Notes: Overdue reminders  ------- Sms reply: YesHistory:Proteinuria Examine:BAR. mm p, CRT <2. LN normal. Laboratory: BP Average - 152/84 (106) Imaging: ULTRASOUNDUrinary bladder: no bladder wall thickening and no to minimal hyperechoic particulate matter (sludge).Left Kidney: Normal echogenicity for cortex, medulla and pelvis. Normal shape on longitudinal and cross sectional view. Normal capsule with no perirenal/retroperitoneal fluid.Right KidneyNormal echogenicity for cortex, medulla and pelvis. Normal shape on longitudinal and cross sectional view. Normal capsule with no perirenal/retroperitoneal fluid.SpleenNormal homogenous echogenicity with regular borders and subjectively normal size.  Vascular structures appeared normal with no obvious truncation.LiverNormal size under last rib with pointed tips to the hepatic lobes. Uniform homogenous echogenicity. All lobes had regular borders and the vessels appeared of normal size and distribution with no gross abnormalities. Hypoechoic to spleen and hyperechoic to renal cortices.Gall BladderNormal hypoechoic echogenicity with minimal to no hyperechoic precipitation. Wall thickness appeared normal.PancreasNo abnormalities observedStomach/Intestines and associated LN'sStomach wall thickness:                              (normal 2-5mm dog and 1.7-3.6mm cat)Duodenual wall thickness:                           (normal 3-6mm dog and 2.0-2.5mm cat)Jejunum/ilium wall thickness:                       (normal 2-5mm dog and 2.0-3.2mm cat)Colon wall thickness:                                   (normal 2-3mm dog and 1.4-2.5mm cat)Normal stomach/intestinal ultrasound with typical shaddowing at times and normal thickness and layers seen. Not distended. LNs not visualised.LNs and other Soft tissue structuresIliac LNs at aortic bifurcation (medial ilian lymph nodes) not visualised.Assessment: Anatomically Kidney appear normal and BP WNL. Plan: Bloods + QML Client Communication:Dear Kath, Just wondering if I could get your help with a case. Ziggy - 9yo, FS, Bichon Frise. Has history of bacterial UTIs and  struvite uroliths so she has monitoring urinalysis q 3 months. On her most recent UA in house I found 3+ protein with an inactive sediment. This was repeatable on 2 more urine samples over the next month. I sent UA + culture and UP:C to lab and the results are attached. Her UP:C was 1.8 with an inactive sediment and negative culture. I have ultrasound her kidneys and sonographically they appear normal. Ziggy is on - Cytopoint injections q 6 weeks - Meloxicam PRN for DJD management I just wanted your advice on where I should go from here. Ziggy is clinically well and is was found incidently. But appears to persistent. Are there any further diagnostics I should consider and should I be starting telmisartan?  Kind regards Ashleigh Porep This dog has significant proteinuria, and if persistent then commencing treatment with telmisartan would be reasonable, as it may be that the dog has glomerular or tubular protein loss but has not yet lost function, and we might be able to prevent that from happening. I would also suggest investigating whether the patient has been exposed to any jerky treats just to rule out a tubulopathy caused by them - it usually results in changes other than those seen here but it would be a reasonable line of questioning. If the owners are keen, then renal biopsy would be performed to assess for glomerular disease but this necessitates sending samples for both histopath and electron microscopy, and has specific transport requirements, so if you do that then let me know and I can provide the details!--- 20/02/2026 12:30:21 FL:Qml form checked, visit number checked. 3 x blood sample tubes to be sent. In fridge ready for afternoon collection--- 20/02/2026 16:10:36 SN:GAP payment requested on arrival - process as saw was ready to pay in outpatients    Vital Signs