C10003971 / invoice 10000

inappropriate urination
urinating outside of litter box, no blood seen, is otherwise eating/drinking & behaving normally TC

Reason for presentation:

GAP ONLY CHECK LIST

*Reason for visit: inappropriate urination

*Primary diagnosis/suspected diagnosis/location: UTI, FIC, pain, other

*Suspect cause: TBC

*Any other conditions being treated (if any): see below

*Date of first clinical signs (if known): ~1 week



SUBJECTIVE/HISTORY:
  Behaviour: FAS (relaxed/mild) 
      Strategy (inhibited) 
      Exited carrier (lifted out) Treats offered (rec creamy) Treats taken (creamy) 
      Handling techniques/preferences (offer creamy, lovely girl) 
  Appetite: (normal) 
  Water Intake: (normal) 
  Urination: (normal)
  Vomiting history: (hairball 1x monthly)
  Coughing: (no coughing)
  Sneezing: (no sneezing)
  Faeces: (normal) Faecal score (2/7)
  Current diet: (Royal Canin dry food, creamy treats, occasional wet food)
  Current Medications: 
     - Pregabalin (APO), 25mg caps, 1 (25mg) PO night before/3hrs prior PVP
     - Frunevetmab (Solensia), 7mg/ml, 1ml (7mg) SC monthly

  Vaccination Status: (O electing not to vaccinate)
  Most recent endo/ectoparasite treatment: (DUE)
  Housing: (indoors only)
  Other animals in household: (one other cat)

OBJECTIVE/ EXAMINATION:
Temperature: Normal
Mentation (BAR) BCS: /9   MCS: (1/normal)
Hydration: (No evidence of dehydration)
Mucous membranes pink and moist, CRT <2 sec
Dental/oral cavity: ()
Nose/throat: (No significant findings)
Thyroid palpation: (normal, no goitre palpated) 
Eyes: No blepharospasm, no ocular discharges, fundic exam (), full ophthalmologic exam not performed
Ears: No significant findings, clean. Otoscopic examination not performed. 
HR: () bpm, normal rhythm, no murmur detected, normal synchronous pulses
RR: () bpm, regular, no significant findings on chest auscultation, normal effort
Abdominal palpation: No significant findings and comfortable on palpation
Urogenital: No significant findings, small bladder on palpation 
Integ: skin and coat healthy, no obvious lesions or lumps noted, normal skin recoil
Msk: no obvious limping noted
Peripheral LNs: No significant findings
Neurological: no abnormalities detected, a full neurological exam not performed
Feline grimace score if applicable (nil pain detected)

LABORATORY:
CBC: ()
PCV/TP: ()
BIOCHEM: ()
BLOOD GAS ANALYSIS: (No significant abnormalities)
USG: ()

ASSESSMENT/CURRENT PROBLEM LIST/DDx:


1. Overweight, goal 5kg then reassess
2. OA
     - Currently well managed with solensia, consider CBD if breakthrough pain occurs 
3. Unvaccianated, O electing to keep indoors without furthur vaccination 

PREVIOUS PROBLEMS NOT CURRENTLY ACTIVE:
1. Hx dental disease, last PCH dental (OCT 23)
2. Hx mast cell tumor removed from neck (OCT 23)
3. Hx inappropriate urination
4. Hx ventral abdominal overgrooming and alopecia 
5. Hx D+
     - Responded well to fibre and probiotics, likely dysbiosis 

PROGNOSIS:
Good

TREATMENT:


      - Meloxicam 0.5mg/ml 0.45ml PO SID




PLAN:





- Discussed the importance of continuing Frunevetmab for osteoarthritis management.
- Recommended reducing food intake by 10% to aid in weight loss. Suggested trying zucchini as a low-calorie treat option. Discussed the possibility of switching to a carbohydrate-restricted weight loss diet. Advised increasing wet food intake to reduce calorie density and improve hydration.
- Discussed the option of performing screening blood tests and blood pressure checks at the next health check in 6 months.

MEDICATION PLAN: 
Continue:
     - Pregabalin (APO), 25mg caps, 1 (25mg) PO night before/3hrs prior PVP
     - Frunevetmab (Solensia), 7mg/ml, 1ml (7mg) SC monthly