C09995130 / invoice 10000

Appointment Notes: Special payment terms existIntern: GLDRAFTHistory:Stormie presenting today for a recheck of TT4, BP, and Creatinine. Previous IM paitent for FIC and relapsing UTI, along with recently diagnosed hyperthyroidism. On 11/23/25, routine bloodwork identified elevated TT4 61 nmol/L (18-45). Commenced methimazole 2.5mg BID PO, and based on the response to medical management, plan was to refer to BVSc for I-131. At her last recheck on 19/12/25 Stormie had been well since starting methimazole, less restlessness and more tolerant of other cats. Continues to maintain good appetite and DUD normally with no LUT signs. Inhouse TT4 was at the low end of normal 11 nmol/L (10-60), and possibility of  iatrogenic hypothyroidism in the future was discussed. Creatinine was normal at 97 umol/L (71-212). On 4/02/26 OR Stormie had been showing signs consistent with hypothyroidism, including weight gain, mild decrease in appetite, decreased energy level, excessive hair loss, and straining during defecation, though stools remain normal. Iatrogenic hypothyroidism was diagnosed and methimazole was discontinued, with the plan to restart at a lower dose if T4 is higher at the enxt recheck.Today, OR was good for a week, then returned to more agitated, more appetite. Was screaming on car ride here, which she never usually does. No issdue with FIC since starting gabapentin. Has tolerated new kitten well. Urination and defecation normal. Hasn't been fasted today.O would like another box of gabapentin.Diet: PurinaOne urinary care (1 sachet + 20ml water BID). Dry available ad lib, however not favouring it. Past pertinent hx: - Relapsing UTIs (Enterococcus) - resolvedCurrent medications:Gabapentin 100mg PO BID Examination Findings:T:         MM: pink and moist P: 200 bpm       CRT: 1-2sR:  32 bpmDemeanour: BAR Hydration: EuhydratedWeight:  6.45kg   (-0.77 since last recheck)BCS: 8/9MCS: 3/3Cardiovascular: WNL , no murmur auscultatedRespiratory: WNL Abdomen: Comfortable on palpation Peripheral LNs: WNL Ocular: WNLEars: WNL Integument: WNL Oral exam: WNLMusculoskeletal: WNLGait: WNLNeurological: Full neuro exam not performed, no neurological deficits observedRectal: NPLaboratory:Awaiting QML resultsAssessment:Problem list:- suspected hyperthyroidism - awaiting T4- Recurrent lower urinary tract signs - resolved- Anxiety - improvedPlan:Awaiting QML results, with the plan to refer to CSS for I-131 therapy.    Vital Signs