C09996650 / invoice 10000

Reason: ACTH StimAppointment Notes: Gets Medication at around 8text sent to client.History: Tilly has started to urinate inside again - started a couple of weeks and more so this week   - noticed regression of increased appetite - looking for food Not noticing drinking more The urination inside is at any time - no change in the character of the urine Eating well - one meal at night and some scooby snack Has Fritz with her Trilostane Resting ok at night Energy levels wnl HL - yelping a bit for no real reason Medications Trilostane 20mg PO at 9.15 Gabapentin - one in the am Test at 1.15 - second part of test at 2.15 Objective:BAR will try to bite is reach arms under her Mm pink CRT <2sec DG 2/4 - O aware dental needed - saving towards this Eyes - bilateral mild nuclear sclerosis Ears wnl HR - 120 no mrumur RR wnl Abdomen - wnl MSKL - there is muscle wastage of the LHL but ambulating well - normal ROM and no pain on stifle manipulation Temp not taken Skin ok - there are several papillomas around the body - some of this do get irritated but Tilly does not lick them Laboratory: Free catch urine: The urine looked clear and the colour was a light yellow Urinaylsis;LEU -         0  cell/uLKET -         0  mg/dLNIT - URO - +1   2.0 mg/dLBIL -           0    mg/dLGLU-          0    mg/dLPRO - +2   100 mg/dLUSG -        1.030PH -           7.5BLD -         0     cell/uLASC -                mg/dLMA -              2.5mg/dLCa -                   mg/dLCR -                   mg/dLPRO/CR - Color: light yellowSediment Exam:There are moderate numbers of struvite crystals and RBCs present Large number cocci found ACTH stim test performed   - Blood at 0 hours - 4 hours post Vetorly   - Synacthen 5mcg/kg IM   - Blood at 1 hours collected Plan: Oral Amoxycillin 200mg PO bid for 7 days for UTI Call Owner with ACTH stim test results later in the day once run    Vital Signs    Weight: 8.7;