C09992744 / invoice 10000

Reason: Recheck And BloodsHistory: Maverick is a 6 month old male neutered Aus Cattle dog x, presenting to ARH Neurology today for MRI investigation of seizures.24/10/25 Maverick presented to RV after having had a GTC seizure. Lasted around 3 mins. Post ictal period of lethargy and disorientation. No known toxin access. PEx WNL. Discharged home, no specific rx. CBC and MBA WNL.30/10/25 presented to RV after second seizures. PEx WNL. Bloods taken, CBC and MBA WNL. Dispensed diazepam tablets to administer PO in event of seizure. 4/11/25 third seizure, not witnessed but found him with foam on muzzle and disoriented. Presented to Emergency vet, dispensed 2w keppra. 10/11/25 recheck with RV. Behavioural changes reported since seizures started; increased anxiety, restlessness, periuria. Increased lethargy and exercise intolerance. PEx WNL. Recommended referral to Neuro. 14/11/25 O confirms history as above. This morning's seizure seemed longer and more violent than previous. After this episode he became very hyperactive, trying to run. For the few nights after a seizure, during sleep at night he maybe seems more twitchy. Barking a lot more now. Exercise tolerance has reduced. NAD on PEx. Primary ddx IE, cannot rule out developmental structural dz. Rx started PHB 50mg PO BID, Keppra 500mg PO TID, MDZ IN in event of seizure. MRI booked in for next week. Plan to repeat bloods with PHB 2-3 weeks, then consider weaning keppra. 5/3/26: dragging PL post partial seizures - post ictal 12h. Seizure history – 4x GTCDescription: Collapse to the side, loss of consciousness, tremoring, paddlingDuration: 3-5 minutesTime of day: varyingActivity on onset: resting or sleepingAutonomic signs: yes; salivation, urinationPre-ictal signs: nonePost-ictal signs: yes; dazed, altered mentation, very clingy to OClusters: noneInterictal period: Interictal signs: nonePossible triggers: noneFamily history of seizures: unknownToxin access: noneOwner's primary goal/concerns today - investigate seizuresAppetite – Maybe a bit more picky recentlyDiet – kibble, meatWater intake – NormalUrination – NormalDefecation – NormalVomiting/diarrhoea – NoneCoughing/sneezing – NoneEnergy levels – NormalExercise/activity – Weight changes – NoneBehavioural changes – More anxious, barking incessantly. No aggression.Preventative medications – UTD with vacc, parasite proxylaxis inc HWIndoor/outdoor access - BothToxin exposure – None notedBIOP – since 10wOther pets at home - nonePrevious medical history –  noneCurrent medications: PHB 100 mg BID MDZ IN PRN Keppra 500mg TID for 48hrs post cluster - this was advised by ECC overnight vet over the phoneExamination findings: T:  38                 MM: pink and moistP:  140bpm        CRT: 1 secR:  pantHydration: EuhydratedWeight: 22kgBCS: 5/9MCS: 3/3Cardiovascular: No murmur auscultated, sinus rhythm, femoral pulses strong and synchronous Respiratory: Clear bronchovesicular sounds bilaterally, normal respiratory effort.Abdomen: Soft, comfortable on palpation. No mass effect appreciableOral exam: No obvious oral lesionsEars: No erythema or discharge notedEyes: No lesions or discomfort notedIntegument: No lesions noted. Lymph nodes: Symmetrical, NSF Musculoskeletal: Full exam np, no obvious lameness.  Rectal: NP Neurologic exam findings: Mentation/Demeanour - BARGait and posture – No significant findingsProprioception – PPR, RS and hopping intact in all limbsMotor function:1.Spinal reflexes – Intact pedal, proximal sciatic, patellar, CTR, and perineal reflexes.2.Muscle bulk - Normal3.Muscle tone - NormalCranial nerves - IntactContinence - IntactVertebral hyperpathia – None noted Nociception - IntactOphthalmic exam - NPAdditional findings - Neuroanatomical localisation: ForebrainProblem list:- SeizuresPotential causes:1. Idiopathic Epilepsy (IE)2. Structural (neoplasia, vascular, infectious, inflammatory)3. Reactive (metabolic vs toxin)Assessment:Gabapentin and traz dose has been helpful given 2h prior to consult. Distracted with food while draWING blood from cephalic veinMaverick's neurological examination today reveals no specific abnormalities. Based on the history of GTC seizures, the neuroanatomical localisation of these clinical signs is the forebrain. Due to patient signalment, previous diagnostic investigation, and seizure semiology, the primary aetiological differential diagnosis is idiopathic epilepsy. It is recommended at this stage to consider MRI to assess for structural causes of seizures.Plan:Awaiting MRI reportContinue AEDsRepeat full bloods with PHB in 2 weeks    Vital Signs    Weight: 26.8;