C09985902 / invoice 10000

Reviewer

Species:CANINE

Breed:Spoodle

Age (years):10

Diagnosis or signs:Trilostane

Consult notes

Diagnosis: Cushingoid Assessment: ACTH stim back- - 4 hours post trilostane; stim cortisol still high, but significantly improved at 212 (down from >700)Sue Foster recc increase dosing 60mg PO BID HT called to discuss with O - left message 04/03/2026 2:57:44 PM HT:O called back, discussed above. O reluctant to change to BID yet as worried may be too much as he does seem a little less energectic than usual (though is still PUPD, appetite good as usual, no other concerning symptoms).  HT advised can continue 60mg SID then re-stim 3-4 weeks but likely still just high and need to increase dose. O aware Plan:Continue 60mg PO SID review stim end march/early april

Animal clinical history (3 most recent)

2026-03-04T00:00:00Z 2:03?pm

Diagnosis: Cushingoid Assessment: ACTH stim back- - 4 hours post trilostane; stim cortisol still high, but significantly improved at 212 (down from >700)Sue Foster recc increase dosing 60mg PO BID HT called to discuss with O - left message 04/03/2026 2:57:44 PM HT:O called back, discussed above. O reluctant to change to BID yet as worried may be too much as he does seem a little less energectic than usual (though is still PUPD, appetite good as usual, no other concerning symptoms).  HT advised can continue 60mg SID then re-stim 3-4 weeks but likely still just high and need to increase dose. O aware Plan:Continue 60mg PO SID review stim end march/early april     Vital Signs

Previous claim history (25)

Date	Claim #	Diagnosis
2026-03-03	C09978417	HYPERADRENOCORTICISM ("CUSHING'S")
2026-02-03	C09847156	HYPERADRENOCORTICISM ("CUSHING'S")
2026-01-31	C09834216	CUSHINGS DISEASE
2018-10-17	C1889427	BITE INJURY - DOG BITE
2018-07-04	C1731808	HEARTWORM CONTROL
2018-07-04	C1731808	FLEA/TICK/WORM CONTROL
2018-06-22	C1731808	EAR (AURAL) INFECTION
2018-02-05	C1534497	EAR (AURAL) INFECTION
2018-01-29	C1534497	BEHAVIOUR DISORDER
2018-01-16	C1506242	BEHAVIOUR DISORDER
2018-01-16	C1506242	HEARTWORM TESTS
2017-12-02	C1506242	BEHAVIOUR DISORDER
2017-10-17	C1386749	CORNEAL ULCER
2017-08-12	C1373850	BROKEN NAIL
2017-07-05	C1252032	VACCINATIONS
2017-07-05	C1252032	HEARTWORM CONTROL
2017-07-05	C1252032	FLEA/TICK/WORM CONTROL
2017-01-31	C1082249	EAR INFECTION
2017-01-31	C1082249	PRURITUS - PRESENTING COMPLAINT
2016-09-14	C0941534	DESEXING
2016-09-14	C0941534	HEARTWORM TEST OR BLOOD SCREEN
2016-09-14	C0941534	HEARTWORM CONTROL
2016-09-14	C0941534	FLEA/TICK/WORM CONTROL
2016-07-06	C0866818	VACCINATIONS OR HEALTH CHECKS
2016-07-06	C0866818	FLEA/TICK/WORM CONTROL

Line items(lines with upstream diagnosis are skipped by the model)

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_prescription_fee	49.50	2026-03-04	—
20000	tstarc_cushings_disease_medication	148.50	2026-03-04	—

UPM+

DG02293HYPERADRENOCORTICISM ("CUSHING'S")DSTP_hyperadrenocorticism_(cushing's_disease)

Variant (sleepy_king)

HYPERADRENOCORTICISM ("CUSHING's")

DSTP_hyperadrenocorticism_(cushing's_disease)

Conf: 0.990

Threshold: 0.18

Above: ✓

Correct?

Yes No