C09988764 / invoice 10000

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Species:FELINE
Breed:Domestic Short Hair
Age (years):4
Diagnosis or signs:D+
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><p>1) Reason: D+<br><br>2) History: <br>- Watery diarrhoea started yesterday<br>- Vomited once yesterday morning on sofa, once this morning<br>- Decreased appetite yesterday, ate dry food and treats this morning<br>- Lives outdoors, sleeps indoors<br>- May have eaten something outside<br><br>Appetite: Decreased yesterday, improved this morning with dry food preference<br>Diet: Felix wet food BID (morning and evening), <span style="background-color: #ffffff; color: #626262;">Royal Canin </span>dry food available between meals, treats<br>Gastric: Watery diarrhoea twice yesterday, single vomiting episode yesterday<br>Resp: No coughing or sneezing present <br>Skin: NAD <br>Meds: None<br>Preventives: UTD vaccines, UTD with NexGard spectra<br><br>Problem: vomiting and diarrhoea<br><br>3) Examination <br>Behaviour: BAR<br>Weight: 5.06kg <br>B/S - 5/9 <br>Oral: mm - pink, crt&lt;1 sec <br>Dental score: 2/4 <br>Eyes: NAD<br>Ears: NAD<br>LNs: NAD<br>Cardiovascular: No heart murmur oscillated, cardiac rhythm - normal<br>Respiratory: Lungs clear, breathing<br>Abdomen: Slightly distended, non-painful, no masses palpated<br>Skin: NAD - No masses or pain.<br>Musculoskeletal: <br>- FLs: NAD<br>- HLs: NAD<br>- ACL, Patella: NAD<br>Urogenital: NAD<br>Neurology: NAD<br>Comments: Yes<br><br>4) Diagnosis: Acute gastroenteritis<br><br>5) DDx: Dietary indiscretion vs infectious gastroenteritis vs parasitic infection vs giardiasis vs coccidiosis vs IBD<br><br>6) Laboratory: In-House Comprehensive+</p>
<table id="idxx_results_table" class="table table-striped table-bordered dataTable no-footer dtr-inline collapsed" role="grid">
<tbody>
<tr class="dtrg-group dtrg-start dtrg-level-0">
<td colspan="6">Haematology</td>
</tr>
<tr id="34208" class="odd" role="row">
<td tabindex="0">RBC</td>
<td>RBC</td>
<td>10.03</td>
<td>6.54 - 12.20 x10^12/L</td>
</tr>
<tr id="34209" class="even" role="row">
<td tabindex="0">Haematocrit</td>
<td>HCT</td>
<td>0.456</td>
<td>0.303 - 0.523 L/L</td>
</tr>
<tr id="34210" class="odd" role="row">
<td tabindex="0">Haemoglobin</td>
<td>HGB</td>
<td>150</td>
<td>98 - 162 g/L</td>
</tr>
<tr id="34211" class="even" role="row">
<td tabindex="0">MCV</td>
<td>MCV</td>
<td>45.4</td>
<td>35.9 - 53.1 fL</td>
</tr>
<tr id="34212" class="odd" role="row">
<td tabindex="0">MCH</td>
<td>MCH</td>
<td>15.0</td>
<td>11.8 - 17.3 pg</td>
</tr>
<tr id="34213" class="even" role="row">
<td tabindex="0">MCHC</td>
<td>MCHC</td>
<td>330</td>
<td>281 - 358 g/L</td>
</tr>
<tr id="34214" class="odd font-red" role="row">
<td tabindex="0">RDW</td>
<td>RDW-CV</td>
<td>28.1</td>
<td>15.0 - 27.0 %</td>
</tr>
<tr id="34215" class="even" role="row">
<td tabindex="0">% Reticulocytes</td>
<td>%RETIC</td>
<td>0.4</td>
<td>%</td>
</tr>
<tr id="34216" class="odd" role="row">
<td tabindex="0">Reticulocytes</td>
<td>RETIC</td>
<td>40.7</td>
<td>3.0 - 50.0 K/µL</td>
</tr>
<tr id="34217" class="even" role="row">
<td tabindex="0">WBC</td>
<td>WBC</td>
<td>7.99</td>
<td>2.87 - 17.02 x10^9/L</td>
</tr>
<tr id="34218" class="odd" role="row">
<td tabindex="0">% Neutrophils</td>
<td>%NEU</td>
<td>69.4</td>
<td>%</td>
</tr>
<tr id="34219" class="even" role="row">
<td tabindex="0">% Lymphocytes</td>
<td>%LYM</td>
<td>20.7</td>
<td>%</td>
</tr>
<tr id="34220" class="odd" role="row">
<td tabindex="0">% Monocytes</td>
<td>%MONO</td>
<td>4.8</td>
<td>%</td>
</tr>
<tr id="34221" class="even" role="row">
<td tabindex="0">% Eosinophils</td>
<td>%EOS</td>
<td>4.8</td>
<td>%</td>
</tr>
<tr id="34222" class="odd" role="row">
<td tabindex="0">% Basophils</td>
<td>%BASO</td>
<td>0.4</td>
<td>%</td>
</tr>
<tr id="34223" class="even" role="row">
<td tabindex="0">Neutrophils</td>
<td>NEU</td>
<td>5.54</td>
<td>2.30 - 10.29 x10^9/L</td>
</tr>
<tr id="34224" class="odd" role="row">
<td tabindex="0">Lymphocytes</td>
<td>LYM</td>
<td>1.65</td>
<td>0.92 - 6.88 x10^9/L</td>
</tr>
<tr id="34225" class="even" role="row">
<td tabindex="0">Monocytes</td>
<td>MONO</td>
<td>0.38</td>
<td>0.05 - 0.67 x10^9/L</td>
</tr>
<tr id="34226" class="odd" role="row">
<td tabindex="0">Eosinophils</td>
<td>EOS</td>
<td>0.38</td>
<td>0.17 - 1.57 x10^9/L</td>
</tr>
<tr id="34227" class="even" role="row">
<td tabindex="0">Basophils</td>
<td>BASO</td>
<td>0.03</td>
<td>0.01 - 0.26 x10^9/L</td>
</tr>
<tr id="34228" class="odd font-red" role="row">
<td tabindex="0">Platelets</td>
<td>PLT</td>
<td>118</td>
<td>151 - 600 x10^9/L</td>
</tr>
<tr id="34229" class="even" role="row">
<td tabindex="0">MPV</td>
<td>MPV</td>
<td>11.6</td>
<td>11.4 - 21.6 fL</td>
</tr>
<tr id="34230" class="odd font-red" role="row">
<td tabindex="0">Plateletcrit</td>
<td>PCT</td>
<td>0.14</td>
<td>0.17 - 0.86 %</td>
</tr>
<tr class="dtrg-group dtrg-start dtrg-level-0">
<td colspan="6">Chemistry</td>
</tr>
<tr id="34231" class="even" role="row">
<td tabindex="0">Glucose</td>
<td>GLU</td>
<td>7.57</td>
<td>4.11 - 8.84 mmol/L</td>
</tr>
<tr id="34232" class="odd" role="row">
<td tabindex="0">IDEXX SDMA</td>
<td>SDMA</td>
<td>8</td>
<td>0 - 14 µg/dL</td>
</tr>
<tr id="34233" class="even" role="row">
<td tabindex="0">Creatinine</td>
<td>CREA</td>
<td>105</td>
<td>71 - 212 µmol/L</td>
</tr>
<tr id="34234" class="odd" role="row">
<td tabindex="0">Urea</td>
<td>UREA</td>
<td>6.1</td>
<td>5.7 - 12.9 mmol/L</td>
</tr>
<tr id="34235" class="even" role="row">
<td tabindex="0">Phosphorus</td>
<td>PHOS</td>
<td>1.32</td>
<td>1.00 - 2.42 mmol/L</td>
</tr>
<tr id="34236" class="odd" role="row">
<td tabindex="0">Calcium</td>
<td>CA</td>
<td>2.21</td>
<td>1.95 - 2.83 mmol/L</td>
</tr>
<tr id="34237" class="even" role="row">
<td tabindex="0">Sodium</td>
<td>Na</td>
<td>152</td>
<td>150 - 165 mmol/L</td>
</tr>
<tr id="34238" class="odd" role="row">
<td tabindex="0">Potassium</td>
<td>K</td>
<td>3.6</td>
<td>3.5 - 5.8 mmol/L</td>
</tr>
<tr id="34239" class="even" role="row">
<td tabindex="0">Chloride</td>
<td>Cl</td>
<td>115</td>
<td>112 - 129 mmol/L</td>
</tr>
<tr id="34240" class="odd" role="row">
<td tabindex="0">Total Protein</td>
<td>TP</td>
<td>85</td>
<td>57 - 89 g/L</td>
</tr>
<tr id="34241" class="even" role="row">
<td tabindex="0">Albumin</td>
<td>ALB</td>
<td>33</td>
<td>22 - 40 g/L</td>
</tr>
<tr id="34242" class="odd" role="row">
<td tabindex="0">ALT</td>
<td>ALT</td>
<td>19</td>
<td>12 - 130 U/L</td>
</tr>
<tr id="34243" class="even" role="row">
<td tabindex="0">ALP</td>
<td>ALKP</td>
<td>29</td>
<td>14 - 111 U/L</td>
</tr>
<tr id="34244" class="odd" role="row">
<td tabindex="0">GGT</td>
<td>GGT</td>
<td>0</td>
<td>0 - 4 U/L</td>
</tr>
<tr id="34245" class="even" role="row">
<td tabindex="0">Bilirubin - Total</td>
<td>TBIL</td>
<td>6</td>
<td>0 - 15 µmol/L</td>
</tr>
<tr id="34246" class="odd" role="row">
<td tabindex="0">Cholesterol</td>
<td>CHOL</td>
<td>2.07</td>
<td>1.68 - 5.81 mmol/L</td>
</tr>
<tr id="34247" class="even" role="row">
<td tabindex="0">Amylase</td>
<td>AMYL</td>
<td>1,096</td>
<td>500 - 1,500 U/L</td>
</tr>
<tr id="34248" class="odd" role="row">
<td tabindex="0">Lipase</td>
<td>LIPA</td>
<td>227</td>
<td>100 - 1,400 U/L</td>
</tr>
<tr class="dtrg-group dtrg-start dtrg-level-0">
<td colspan="6">Endocrinology</td>
</tr>
<tr id="34249" class="even" role="row">
<td tabindex="0">Total T4</td>
<td>T4PLUS</td>
<td>26</td>
<td>10 - 60 nmol/L</td>
</tr>
</tbody>
</table>
<p>7) Client Comms: <br>- Discussed blood test options and costs<br>- Explained treatment plan with antibiotics and probiotics<br>- Pet insurance should cover blood work costs<br>- Blood results discussed - overall unremarkable<br>- Explained suspected gastroenteritis from eating something inappropriate while outside<br>- Discussed antibiotic recommendation due to gastroenteritis<br>- Advised to monitor for continued diarrhoea and bring sample if persists<br>- Advised to monitor for continued vomiting<br>- Anti-emetic injection considered but not dispensed as no vomiting today<br><br>8) Treatment: Yes<br>- Metronidazole liquid 1.2ml PO BID for 7 days<br>- Probiotics 15ml 2ml PO BID until finished<br><br>9) Plan: <br>- Recheck in 2 weeks<br>- Faecal sample container provided for collection if diarrhoea continues<br>- Monitor for continued vomiting - medication available if needed</p></html>

Animal clinical history (3 most recent)

2025-12-23T00:00:00Z 09:33:00
1) Reason: Annual F3 vax booster, occasion V+2) History:Appetite : normalOccasion V+ Twice a month, eating grass. Normal appetite and energy level after V+, V+ hairball and bile.Unsure bowel movement as toilet outside.Resp: no C& S presentMeds: noPrevention: UTD with monthly Revolution spot onMainly indoor cat, with backyard accessDiet: Fancy Feast and Felix cat wet and dryFussy eater, tried cat Greenies but doesn't like it.Examination:Behavior: Timid but tolerate exam and handling well todayWeight - 5.3 kg, B/S - 4/5Oral: Garde 1-2 dental with mild gingivitisEyes: NADEars: NADChest: lungs clear, no heart murmur oscillatedLNs: NADAbdomen: NADGastrointestinal: NADSkin: NADMusculoskeletal: NADUrogenital: NADNo rectal temp taken due to temperamentComments: Fit for vacOccasion V+ DDX: Primary GI vs Secondary GI6) Treatment:F3 given s/c, dorsal shoulder blade7) Plan:Annual F3 vax due in 12 monthDiscussion on blood test with T4 as health assessment, O not keen todayRecommended cat laxative products twice a week for 2-3 weeks and close monitoring on V+ condition, recheck if worse or increase in frequency or concern.Weight control and dental care recommendedGiven dental estimate $770-800, O to book in when ready
2024-10-05T00:00:00Z 09:19:49
Examination Text:1) Reason: Annual  F3 vax2) History:  eating royal canin adult food Appetite : normalGastric : no v/dResp: no C& S presentMeds: noPrevention: UTDMainly indoor catExamination:Behavior: friendly Weight - 5 kg,  B/S - 4/5Oral:  mm - pink, crt<1 sec, dental score  0/4Eyes: NADEars: NADChest: lungs clear, no heart murmur oscillatedLNs: NADAbdomen: NADGastrointestinal: NADSkin: NADMusculoskeletal: NADUrogenital: NADComments:5) Diagnosis: BAR NAD,  annual F3 vax 6) DDX: overweight 7) Client Comm:  talked about weight loss, make sure she doesn't gain anymore weight as owner is concerned about early arthritis 8) Treatment: F3 dorsal shoulder bladegoes outside- O does spectra at home 9) Plan: Annual F3 vax due in 12 month
2023-10-19T00:00:00Z 19:01:28
Examination Text:nail clip to be done during boarding

Previous claim history

DateClaim #Diagnosis
No prior claims.

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

LinetstarcAmountDateUpstream diagnosis
10000tstarc_diagnostic_test_-_blood_test340.002026-03-05—
20000tstarc_consultation97.202026-03-05—
30000tstarc_antibiotics_-_metronidazole35.022026-03-05—
40000tstarc_probiotics39.382026-03-05—

UPM+

  • DG02012FAECAL APPEARANCE ABNORMAL - DIARRHOEA - PRESENTING COMPLAINTDSTP_clinical_signs_-_diarrhoea

Variant (sleepy_king)

GASTROENTERITIS
DSTP_gastroenteritis
Conf: 0.500
Threshold: 0.68
Above: ✗
Correct?
Acceptable?
Reason (acceptable)
Diagnosis description