C09987678 / invoice 10000

Appointment Notes: Blocked bladder Tx - TBC from Gx SouthportConsult Time: Triage - 1755   Consult - 1815History:- 11-month-old cat presented to the primary care veterinarian this morning for an inability to urinate.- Difficulty urinating was first observed this morning; was seen straining in the litter box without producing urine.- Seen by primary care veterinarian on Friday for a gash on his paw, which was noticed the Friday prior. He was on a course of antibiotics for one week.- The paw wound was cleaned under sedation on Friday.- The primary care veterinarian noted glucose in his urine on Friday and advised to present immediately if he stopped urinating.- He was urinating normally over the weekend until this morning.- unblocked at GP this afternoon, transferred for ongoing care - reported to have no resistance to ucath introduction, no discernible physical obstructionObjective:HR 180, RR 20, mm pink, moist, CRT 1.5 sec, temp 38.5CV – Clear heart sounds, no murmur or arrhythmia noted, strong synchronous pulses.Resp – Normal RR and RE, normal bronchovesicular sounds, no crackles or wheezes heard.GIT – Abdomen soft on palpation with no pain response or palpable abnormality.UG – Bladder soft on palpation, IDUC in situNeuro – Normal mentation, no ataxia, appropriate cranial and peripheral nerve responses.MSK – No lameness, no pain on manipulation or palpation of neck, spine, limbs, hips/pelvis.Integ – Clean coat, healing wound on RF below dew claw, no ectoparasites noted.Eyes – Clear corneas, no discolouration, swelling or discharge.- see flowsheet for overnight obs and nurse notes.Subjective:Appeared calm during initial stabilisation and placement of urinary catheter. Owner reports he enjoys human affection and attention.Assessment:Urinary obstruction, likely secondary to functional urethral spasm rather than a physical blockage, given the ease of catheter placement once sedated. Stress is a significant potential trigger. Awaiting urinalysis results from the primary care veterinarian to check for crystals.Plan:- Hospitalisation for ongoing management of urinary catheter and monitoring of urine output for a recommended period of 24-48 hours.- Continue IV fluids to maintain good urine production.- Continue gabapentin and buprenorphine for anxiolysis and analgesia.- The urinary catheter will be secured to prevent tugging.- Consider daily blood tests to monitor electrolytes.- Await urinalysis results from the primary care veterinarian; urine will also be collected from the bag for in-house analysis overnight.Treatment:Buprenorphine 0.02mg/kg transmucosal q12hGabapentin 100mg p/o q12hClient communication:Discussed the plan for overnight care, including management of the urinary catheter, IV fluids, and pain/anxiety medication. The recommendation for 24-48 hours of hospitalisation was explained. The option of transferring back to the primary care veterinarian in the morning was discussed, noting that remaining here would likely be less stressful due to avoiding transport. A detailed cost estimate was provided. The overnight 'peace of mind' package cost is $361, plus urinary catheter management of approximately $150, for a total of around $500. From tomorrow morning, standard hospitalisation costs apply, estimated at $750-$1000 per 12-hour period, excluding additional costs like blood tests. This could amount to approximately $2000 for a 48-hour stay. A deposit of $476 was taken for the initial overnight period. The owner will discuss the options with their partner and contact their primary care veterinarian in the morning to compare ongoing costs. A photo update will be sent to the owner between 10-11 pm tonight.Next update 5-6am.    Vital Signs    Weight: 5;