C09993885 / invoice 20000

Reason: FlUTDAppointment Notes: Blocked bladder Tx - TBC from Gx SouthportUnblocked at Gx Southport yesterday with indwelling U cath Also recently treated for FL wound with convenia injection and meloxicam Early in evening very irritated by U cath and managed to remove 3 of the securing sutures for U cath despite E collar in placeUrinating around U cath in litter tray Elected to remove U cath at 7pm rather than waiting until midday tomorrow as causing too much irritation and urine flowing clear IV catheter also dislodged by sterling at this time Bright, eating and drinking well No azotaaemia or lyte derangements on bloods so elected not to cause further stress replacing IV and U cath Settled and sleeping well after removal of U cath, urinated in tray - small sized urination O updated on progress and likely to be able to be discharged in morning Continue with gabapentin and oral meloxicam, buprenorphine discontinued as seems very sensitive to it No indication for abs, recommend urinary diet for future    Vital Signs    Weight: 5;       

Reason: FlUTDAppointment Notes: Blocked bladder Tx - TBC from Gx SouthportFor lox billing    Vital Signs    

Reason: FlUTDAppointment Notes: Blocked bladder Tx - TBC from Gx SouthportConsultation Time:History: Ongoing care post FLUTD from RV  04.03.FR dew claw was treated with ab (amoxyclav tabs  & lox from  23.02 )Then recheck on 27.02, PO amoxyclav stopped as convenia given  Unsure when last oral Lox was given  (to be confirmed with O  )Iv replaced this am u/a result  in med note (however u/a attached in the file  is from  27.2, error in date ? )No blood work was done when unblocked  Med PO buprenoprhine & gabapentin  100 mg were dispensed from RV (Gabapentin 100 mg BID has been given even label said 0.5 capsule, unsure if label error or not)Possibly opioid sensitive? As pacing hyperactive in the cage with PO buprenorphine ? From GP note, 100 mg of Gaba was given 0930 &1100 before GA for u cath placement Thus pacing can be from high dose of gaba vs PO buprenorphine  (given  2pm )Subjective: V.BAR Objective: Temp      39.5     MM    pink           CRT      < 2sec       HR      168       FP ok BCS:   /9                       Wt:   kgPain Score (CSU):   /4CV:  NAD       RESP:   NAD           RRGIT:   NADU/G:  NADNeuro:  NADM/S:  NADInteg:  NADOphth:  NADLNs: NADProblem List: FLUTD  Assessment: U cath flowing wellIvft  x maintenance -> 1200 -> down to maintenance Urine colour: tinged with blood clot ? With  clear UOP : 3.8ml/kg/hr when onx 2 maintenance UOP : 2.5 ml/kg/hrChem 10 w/ SDMa & lytes: wnl Treatment:PO gabapentin  100 mg bidPo lox for 4.5 kg mark  ie 0.45ml orally once daily for 3 days to start 05.03 PM STOP PO buprenorphine as seems v. Sensitive toward opioid. Plan:U cath removal next day  PM  06.03.26Recc c/d vs s/o diet if possible Continue gaba possibly 50 mg bid rather than  100mg at home +/- PO buprenorphineCalled o around  1500Updated as above Last lox was given  tues Pm (been used for 4-5days)Bill updated Ongoing cost Q 12hours  $750-1000Next update  next day 0500-0600    Vital Signs    Weight: 5;