C09994873 / invoice 10000

Reviewer

Species:CANINE

Breed:Spoodle

Age (years):10

Diagnosis or signs:ACTH Stim test for cushing

Consult notes

ACTH Stim test for cushing

Animal clinical history (3 most recent)

2026-03-06T00:00:00Z 12:00:00

HISTORY: ACTH Stim test for cushing

2026-03-04T00:00:00Z 12:00:00

WEIGHT: 21.30
HISTORY: H - Long history with Pen Vet - 
1. Thought to be cushingoid however didn't want to pursue testing as want to keep things non invasive and don't want to do liver biopsy
2. Heart murmur, don't record RRR however no cough, no pot belly
3. Significant epileptic, on phenobarb and pexion. Usually seizures around 5 weekly, last couple of have been able to use the keppr with the preictal signs and feel they have cut it off so last seizure was Jan 10 with pet sitters who might not have been able to spot those signs. Family extermely alert and proactive to her seizure activity
Not had phenobarb levels at all - discussed low not really needed however too ghigh can be an issue with behaviour and jittery signs
4. Presenting problem - last 5 out of 10 nights has woken after approx 4 hours and then been panting and puffing for hours, worked up and not able to settle, takes 3-5 hours to get her to settle.


Skin lesions started to break out again
Was suspected to have CCS however didn't want to do

Previous claim history (23)

Date	Claim #	Diagnosis
2026-03-04	C09988287	BEHAVIOURAL THERAPY
2026-02-27	C09985055	EPILEPSY
2026-01-27	C09848985	SEIZURES
2025-12-27	C09681259	SKIN (CUTANEOUS) ABNORMALITY - ERUPTIONS/HIVES/RASH - PRESENTING COMPLAINT
2025-12-03	C09598489	SEIZURE DISORDER
2019-09-21	C2457072	SEIZURES
2019-07-06	C2322065	VACCINATIONS OR HEALTH CHECKS
2019-04-27	C2201729	VULVAL DISORDER
2019-03-03	C2201725	MASS LESION
2019-02-11	C2070941	SEIZURES
2019-01-14	C2022302	SEIZURES
2019-01-14	C2022302	FLEA/TICK/WORM CONTROL
2019-01-14	C2022302	HEARTWORM CONTROL
2018-10-13	C1876557	SEIZURES
2018-08-30	C1815595	SEIZURES
2018-08-06	C1780054	SEIZURES
2018-06-29	C1724102	VACCINATIONS OR HEALTH CHECKS
2018-06-29	C1724102	HEARTWORM CONTROL
2018-06-29	C1724102	FLEA/TICK/WORM CONTROL
2018-05-05	C1645756	SEIZURES
2018-04-22	C1627018	SEIZURES
2018-04-06	C1629459	SEIZURES
2018-04-04	C1600449	SEIZURE(S) - PRESENTING COMPLAINT

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

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_diagnostic_test_-_blood_test	150.00	2026-03-06	—
20000	tstarc_diagnostic_test_-_acth_stimulation_test	230.00	2026-03-06	—

UPM+

DG02293HYPERADRENOCORTICISM ("CUSHING'S")DSTP_hyperadrenocorticism_(cushing's_disease)

Variant (sleepy_king)

SEIZURE DISORDER

DSTP_seizure_and_epilepsy

Conf: 0.820

Threshold: 0.19

Above: ✓

Correct?

Yes No

Acceptable?

Acceptable?Not acceptable — misleading outcome to client but no financial impactNot acceptable — potential financial impact

Reason (not acceptable — misleading)

Diagnosis description