C09999150 / invoice 10000

Weight (Kg):5.20
History:05 Mar 2026 08:59:45 am
Here for cysto, USG/sedivue/dipstick and LDDST for suspected HyperA

0 hours @ 8:54 collected
dex 0.03mL IV @ 8:55am
4 hours @ 12:54 pm
8 hours @ 4:50 pm

05 Mar 2026 09:11:14 am
o mentioned a small lump on Latte's armpit (so small she struggled finding it)
FF palpated (felt either like a lymph node or a tiny pimple)
told o to monitor for growth as its probably to small to test
FF

Diagnostics:

UA:
USG 1.040
pH 7.0
Rest within normal limits

Cortisol resting/0 hour = 198.8
Cortisol - 4 hr Post Dex < 13.8
Cortisol - 8 hr Post Dex = 50.5

Assessment:
Supportive of HyperA, pituitary-dependent

Plan:
BH to call tomorrow

05 Mar 2026 10:17:36 am
Phone transferred from reception as O wanted to speak to a nurse. O asked how Latte was doing and asked if she would be seeing a vet this afternoon. I advised ber BH that the urine test was normal, but the blood results won't come back until tomorrow, so a vet will call her once we have them to run through the findings. This afternoon will be a handover by a nurse. Advised to pick up Latte at 4:45pm. O said if any changes, please call her sister (number on form)
SVH


06 Mar 2026 12:35:20 pm
Comms:
Discussed result.
Recommended waiting for BH to contact cardiologist regarding management given Latte has a pacemaker, client happy to wait to hear before starting medication.
Mentioned results indicated PD, and can go for referral appt at SASH, however would not recommend surgical intervention.
Discussed going very slow and easy on Latte's trilostane doses and will require repeat blood work.
Discussed possibility of client taking BP's at home (client is a nurse).

Plan:
BH to contact cardiologist re management, if cardiologist replies with recommendations and BH to not here, can a vet please sort trilostane (will need to ring client for capsules vs suspension) as client very keen to get started on management.
Trilostane 0.5mg/kg PO twice daily to start off with, expect to have to increase to 1mg/kg.

BH

06 Mar 2026 03:47:28 pm
See comms from SASH:
Recommend 0.5-1mg/kg and dose for clinical signs.
BP's BEFORE initiating medication and at follow up ACTH bloods.

Comms with client:
Relayed SASH info: BP's prior to starting dose and on follow up.
Therefore need client to come in tomorrow morning (before consults) for BP's in a consult room with owner.
Asked client to call at 8am to make sure no crazy emergencies are standing at the door and okay for her to still come.
When she arrives, please take her to a consult room, turn the light off, ask the client to sit with her, nurse to take MULTIPLE readings until they are consistent.
Nurse please check values with vet briefly before letting client leave to ensure diagnostic.
Vet to call later with results if not avaliable,
Client consented to ordering Trilostane liquid.

Dose for trilostane = 0.5mg/kg = 2.6mg
@ 7mg/mL 50mL bottle, requires 0.37mL twice daily, CHICKEN FLAVOUR
Ordered through bova.
BH