C10004104 / invoice 10000

Reason: RecheckVerified: NOHISTORYPresenting for: Follow-up consultation for urinary issues and monitoring response to current treatment protocol.Historical Conditions:- Previous urinary tract issues with repetitive obsessive behaviour around litter box- History of going to litter box 6-7 times previously, now reduced to 1-2 timesDiet:- Currently refusing prescribed urinary diet (wet food)- Only licking water from wet food sachets, leaving all solid food- Refuses all dry food since kittenhood- Owner unable to hide medications in food due to poor appetiteDrinking/Urination:- Significant improvement in litter box behaviour - frequency reduced from 6-7 visits to 1-2 visits- No longer showing repetitive obsessive behaviour with litter box- When using litter box now, goes to toilet and leaves immediately- Owner concerned about hydration due to reduced food intakeCurrent Meds:- Minipress (continuing)- Antibiotics (7 days completed, extending to 10 days)- Gabapentin 100mg - owner giving half capsule BID (effectively 1 capsule daily total)- MeloxicamEXAMBehavioural:Owner administered pre-visit medication to calm patient. Patient showing stress and vocalising displeasure during examination. Hiding under towel and expressing annoyance but not showing previous extreme aggressive behaviour. Patient may attempt to bite during handling.ASSESSMENTUrinary tract infection - significant clinical improvement with current treatment protocol. Repetitive litter box behaviour completely resolved. Patient now exhibiting normal toileting behaviour.Inappetence - likely related to prescribed urinary diet. Patient refusing wet urinary food and has lifelong aversion to dry food.PLANChanges to Existing Meds/Tx:- Continue antibiotics until Wednesday (extending to 10 days total)- Reduce Gabapentin to half capsule once daily (morning administration preferred for better alertness)Diagnostics:- Collect urine sample Thursday or Friday after completing antibiotics- If sample shows concerning findings, restart antibiotics immediatelyAdditional Discussion:- Owner to continue with current urinary diet despite patient's reluctance- Consider appetite stimulant if feeding issues persist- Monitor hydration status given reduced food intake- Owner has leftover antibiotics available to restart if needed based on urine resultsClient Comms:- Bring urine sample Wednesday-Friday for analysis- Stop antibiotics Wednesday evening- Continue half dose Gabapentin once daily in morning- Maintain strict urinary diet - no reverting to previous food- Contact clinic if any return of repetitive litter box behaviour    Vital Signs    Weight: 4.95;