C09997078 / invoice 10000

Species:CANINE
Breed:Labrador
Age (years):5
Diagnosis or signs:See notes
Consult notes
06/03/2026 HOSPITAL NOTES:
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Dog Venous **
A. Gases:
pH:   7.394   (7.350-7.450)
pCO2: 40.0  (35.0-38.0 mmHg)
pO2:   55.0  (85.0-100.0 mmHg)
cHCO3-: 24.4  (15.0-23.0 mmol/L)
BE (ecf): -0.4  (-5.0-0.0 mmol/L)
cSO2: 88.0 (90.0-100%)

B: Chem:
Na+:   151  (139-150 mmol/L)
K+:   4.0    (3.4-4.9  mmol/L)
Ca++:   1.41 (1.12-1.40 mmol/L)
Cl-:  112   (106-127  mmol/L)
TCO2: 23.6  (17.0- 25.0 mmol/L)
Hct:    20  (35-50%)
cHgb:  12.2  (12.0-17.0 g/dL)
BE (b):     (-5.0-0.0 mmol/L)

C: Meta:
Glu:   7.2   (3.3-6.4  mmol/L)
Lac:   1.14   (0.60-2.90 mmol/L)
BUN:   13 (10-26 mg/dL)
Urea:  4.7  (3.6-9.3 mmol/L)
Crea:  74   (44-115 umol/L)
BUN/Crea: 15.6  (0.2-400.00 mg/mg)
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06/03/2026 GAP Hx
Presented for 2d Hx of inappetance, vomiting and lethargy
Bloods unremarkable
Abdo US/rads show large abdominal effusion- abdominocentesis performed, cloudy pink tinged fluid
Cytology large round cells and neuts, no evidence of bacteria. 
Fluid glucose equal to blood glucose

Ddx neoplasia, inflammatory 

Plan: send to PVE Cannington for care and CT scan, and hopefully get novovet to get onto cytology quicker that idexx. 

Animal clinical history (3 most recent)

2025-08-28T00:00:00Z 11:28:25
Record complete (Y/N): y

Reason: Vaccination

History: Bruce has presented for vaccinations, no concerns, EDUF normal, no V+/D+ and he is not on any medications.

Pre-existing conditions: overweight
Current medications: no medications being provided at time of examination
Prophylaxis: vaccination and parasite prophylaxis is UTD

Appetite: normal
Drinking: normal
Urination: normal
Defecation: normal
D+, V+, coughing? none

PE
Mentation: BAR
BCS: 4/5
MM: pink and moist
CRT: 1-2s
HR: 110 bpm, no murmurs or arrhythmias detected
PR: normodynamic and synchronous
RR: normal effort and no abnormal lung sounds
Temp: not taken
Ocular: no abnormalities noted on cursory examination of both eyes
Oral/dental stage: 1/4
Ears: no abnormalities noted on cursory examination of both ears
LN: submandibular, prescapular and popliteal are small, symmetrical, non-painful and WNL on examination
Abdo: no pain on abdominal palpation, no organomegaly or masses palpated
Integument: normal skin turgor, no significant abnormalities
Urogenital: no significant abnormalities 
MSK: ambulatory, normal gait and strength noted. No evidence of lameness
Rectal exam: not performed
Neuro exam: no evidence of neurological impairment or altered mentation. Full neurological exam not performed

Treatment:
Fit for vaccination

Vaccination given: Nobivac DHPPi C4 SC + Nobivac BB PO
Batch number: 2515101, 02541174C
Next vaccination due: KC1 Aug 2026
2025-08-21T00:00:00Z 11:37:31
*** NO SHOW for today's vaccination app ***
sms sent 
2024-12-18T00:00:00Z 14:20:40
Reason/concerns:  Scratching face
History:
O has noticed Bruce scratching the sides of his face for the last several weeks, now has crusty lesions on the sides and top of face
Otherwise is doing well, O has no other concerns. 
Nil V+, D+, EDUF as normal
Vaccination UTD, prophylaxis UTD (TWP)

Examine: 
Mentation: BAR, likes treats
BCS:4 /5   
MM: Pink          
CRT: 1-2 seconds
HR: 80                           beats/min
RR: Pant                             breaths/min
Temperature:   NE           degrees Celsius
Mandibular LN mildly enlarged 

Ocular: No abnormalities noted on cursory examination of both eyes.
Oral/Dental stage: 1
Ears: Mild erythema on cursory examination of both ears.
Cardiovascular: No audible murmur or arrhythmia 
Respiratory: Respiratory rate and effort normal
Gastrointestinal: No pain on abdominal palpation. No masses or abnormalities palpated.
Integumentary: Thick, dense matting and crusts of L and R side of face, several multifocal crusts on dorsal aspect of head. Ventral erythema of FL bilaterally
Musculoskeletal: Normal gait and strength noted. No evidence of lameness.

Problem and assessment List:
1. Hotspots/ superficial pyoderma
A. Lesions clipped up to reveal ~ 6cm x 4cm superficial ulceration LHS, and ~4cm x 3cm superficial ulceration of RHS. Cleaned with dilute chlorhexidine. 

Diagnostics performed (i.e. bloods, radiographs/ultrasound, ear cytology, urinalysis):
- None performed 

Treatment with medication 
dose rates (if any):
Cephalexin 24mg/kg BID for 14 days
Prednisolone 20mg tapering 

Client Communication
& Plan: 
Recheck in 14 days

Previous claim history (7)

DateClaim #Diagnosis
2024-12-18C8095045HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2023-04-04C5763361DIARROHEA
2022-09-15C5105657MISCELLANEOUS CONDITIONS
2022-09-03C5072703DIARRHOEA - PRESUMED SELF-LIMITING
2022-09-03C5073801DIARROHEA
2022-08-31C5065926DIARROHEA
2022-08-28C5052988VOMITING - OTHER - PRESENTING COMPLAINT

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

LinetstarcAmountDateUpstream diagnosis
10000tstarc_diagnostic_test_-_blood_gases87.452026-03-06
20000tstarc_diagnostic_test_-_blood_test295.002026-03-06
30000tstarc_procedure_fee_-_radiology625.002026-03-06
40000tstarc_sedation_for_procedure212.002026-03-06
50000tstarc_hospitalisation180.002026-03-06
60000tstarc_consultation109.002026-03-06

UPM+

  • DG02146VOMITING - OTHER - PRESENTING COMPLAINTDSTP_clinical_signs_-_vomiting

Variant (sleepy_king)

ANOREXIA - PRESENTING COMPLAINT
DSTP_clinical_signs_-_anorexia
Conf: 0.200
Threshold: 0.82
Above:
Correct?
Acceptable?
Reason (acceptable)
Diagnosis description