C10002764 / invoice 10000

Appointment Notes: poss urine incontinence tc History:Increase in incontinence in the last week - incontinence in the bedding, wet tail O suspects visiting water bowl more frequently in recent week Voiding urine in consult room which is unusual for Sandy Does not seem to be urinating more frequently Panting more then usual recently Change to grazing appetite in last 48 hours but still finishing food EDDU: Reduced appetite last few days - still eating full meal but taking longer to eat, No V+, no D+, PUPD ? Examine: 1. BAR2. Vitals: HR 100 RR 24 MM pink CRT <2 3. Body condition: 6/94. Oral exam: Grade 2/4 mm pink moist CRT <2 5. Eyes: NAD6. Skin / ears: NAD7. Auscultation: No HM or arrythmia, lung fields clear8. Abd palpation: Lip smacking when palpating abdomen 9. Palpable lns: NAD10. Anal glands / perianal area: - Laboratory: Free catch UA USG 1.020 Ph 7.5 Pro + Urine strong odour Grossly normal straw coloured urine White sediment when spun down Sediment: Occasional cocci Assessment:Incontinence DDX: UTI (vs contamination from free catch), USMI, Underlying systemic dx causing PUPD Offered tx trial amoxyclav vs bloods Treatment:AmoxyClav 250mg - 3/4 tablet PO BID 6 days Plan: Phone update 5 days If ongoing incontinence recommend bloods If bloods NAD recommend tx trial Propalin     Vital Signs    Weight: 12.3;