C10003120 / invoice 10000

Reason: Incontinence Continueing NZAppointment Notes: Needed Follow up as not betterHistory: doign wellRepsonded to incurin imemdiatelyOverall open diagnosis:4+ blood in urine and came on suddenly according to owner -is going a bit senile: drinking more? Sometimes just drinks alot out of the blue, o wondering of going a bit senilePlan: reduce incurin to 3 doses per week Then 2 doses per weekIf recurs consider-urine culture-biochem re pu/pd-water intake mxUpdate in 3 weeks when due zydax and beransa    Vital Signs    

Reason: Possible Uti/Bernasa Appointment Notes: KAHistory: Presenting for beransa and zydax tofay Is urinating more often over last 24 hours - has had 3 accidents in the house- about 10 urinations in last 24 hours - when owners got home last nigth was puddle of urine where she was laying Owner hasn't noticed any straining Owner thinks urine is more yellow than would expect Eating, drinking, defecating normally Meds: beransa and zydax onlyExamine: 1. BCS:   3.5  /52. Integument: nad 3. Musculoskeletal: nad 4. Teeth: nad 5. Eyes: nad 6. Ears: nad 7. Lymph Nodes: nad 8. Cardiovascular/Circulatory:   nad  9. Respiratory/Pulmonary:  nad 10. Uro-genital: brown staining of fur around vulva, was dribbling urine in consult room, did have a smell to it and urine was yellow with brown flecks 11. Gastrointestinal: nad ->11a Anal Sacs: not examined 12. Behaviour: BAR13. Other: vitals wnl Assessment: Leaking urine and polyuria ddx: urinary incontinence (has trialled incurin in 2024, owner doesn't remember if helped or not) vs UTI vs uroliths vs cystitis vs other Recommend urinalysis to screen for UTI or other causes - if wnl, consider incontinance as cause of leakign as woke up in puddle of urine, but unusual to get flare up so acutely of incontinance. Plan: Owner has somewhere he has to be today, so plan to keep in hospital for day, get cysto sample and run urinalysis, go from thereAlso needs beransa and zydax whislt in hospital Aim to pick up after 5pm today Laboratory: Urine- 4+ blood - was a cysto sample - no bacteria- no crystals - 1+ protein- USG of 1.016 - dilute due to renal reasons or polydipsia due to incontinanceTelephone Call: Updated James on urine resultsOptions to take blood to look at kidneys vs trial incontinence treatment- is on beransa but has been on beransa since March 2023, so unlikely to all of a sudden by causing issue, can't be 100% sure Treatment: 15mg beransa SC Gave 300mg traz whilst in hospital today0.81ml zydax SC Plan:Trial incurin - give daily for 7 days, then recall to check in and discuss tapering dose if controlling incontinanceBeransa and zydax next in 4 weeks Owner picking up at 5pm - discharge handed over to and booked in with ST    Vital Signs    Weight: 26.6;       

Reason: Beransa Injection JJAppointment Notes: Overdue remindersHistory:Treatment:     kg dose beransa Plan:    Vital Signs    Weight: 26.6;