C09988075 / invoice 10000

Reason: Aurora Attached- Emailed both Stephen and Jane with urinalysis results and an interpretation of all findings, this can be found in commsI have asked the owner to continue antibiotics for at least 3 days, despite no obvious evidence of urinary tract infection - there is bladder wall thickening and I want to check whether antibiotics change the PUPD/nocturiaI have also recommended that owners obtain Denamarin/Hepatoadvanced; they may call to get this from ARHI have asked the owners to call Friday afternoon with an update - speak to THJ at that time if possible--------------------------------Summary:Ozzy has multiple severe comorbidities that are interrelated> neurological and orthopaedic problems that are likely debilitating and causing severe pain:Marked spinal arthrosis and several IVDD, some of these compressing the spinal cordMild lumbosacral diseaseMarked hip dysplasia and sublux of the right hip (with toggle pin in place)Moderate stifle arthrosisHe has a caudate liver lobe mass, this most likely explains the AP elevation, although he also has a polypoid growth in the gall bladderHe has urinary bladder wall thickening, this is most suggestive of chronic cystitis, though currently urine culture is negative.PUPD may be due to pain, liver disease, or indolent UTI; an endocrine cause is less likely as adrenal glands and blood pressure are normal. Renal disease is less likely as there is no azotaemia, but stage 1 renal disease remains possible.There is concern regarding 3 small nodules in the lungs; these could be benign osteomata, however metastasis (of presumably the liver mass) is also possible.  The panting is not sufficiently explained by this and may therefore be due to pain, higher corticosteroid concentration in the body due to liver disease    Vital Signs