C10004523 / invoice 10000

Reason: Unwell Appointment Notes: Special payment terms exist, Overdue remindersnot herselfnot wanting to eatHistory: Started trilostane Thurs 0.6mlOs away and ate ok whilst house satOk SAt nightSun AM, didn't want food.Gave Cortate; ate 1/2 hr laterYest a bit unsteady on her feet. Couyldn't get comfortable.Walking backwards.Last night & thids morning, ate diiner and breakfast this morning.No6t yet resumed trilostane.Only had 1 dose CortateMaybe just a bit quieterYest seemed to be sleeping more?Was on trilostane at 0.6ml for about 10 days total.Last trilostane Sat morning.1 dose Cortate Sun AM0.2ml Synacthen Hospital Admission Consent FormReason for admission and planned treatment, diagnostic testing and/or monitoring : ACTH stim test and full bloodsPhone: 0407 268 871Name: Renee English Is this the preferred contact number? If not, please complete below: YesEstimate: : 980View full form at https://api.vetcheck.it/share/AU_87a53420-edf3-433d-a3ff-168d519dc064--- 09/03/2026 12:19:59 PM BRC: JP0 hour bloods taken 0.2ml Synacthen given IV @ 12:15pmLaboratory: PCV: 42% Plasma: ClearOn 2026-03-09, Ally English was admitted for ACTH Stim under the care of Dr Birgit Johnston and . Tasks/Procedures Performed: IVC in | 0 | .Medications Administered: Synacthen (dog) | 0.2 | IV.Laboratory Tests: Blood 0 hour | 0 | .View full Chart - Hospital Realtime at https://api.vetcheck.it/share/AU_69504fd5-18bd-4812-ada8-065aa3108db3    Vital Signs    Weight: 10.1;       Temperature: 39.06;       HeartRate: 124;       

Reason: ACTH Stim, C5 And Proheart Appointment Notes: Special payment terms exist, Overdue remindersHistory: 1.2ml trilostane once daily at nightBeen wellUrinates in same spots as new male dog; o initially thought that was a urinary issue but realised that she is just marking on top of other dog's urine spots Was a bit off this morning. Picked at her dry food, but ate cubes of meat okAte fine last night, and got trilostane ok On Cardisure; no change in RR Examination: QARMM pink, moistCRT okDental dz gd2; has had prior extractions.Bilat lens opacitiesHM gd 5Abdo soft on palpn.T wnl Assessment: Will call Vetnostics to make sure worthwhile with proceeding with testHad ACTH stim test done 11/10/25 when unwell. Trilostane dose was reduced from 120mg BID to 120mg SIDAt rpt test done on 30/10/25, was already on trilostane once daily at night. Test showed good result. What does that mean in context of dosing the night before???Will ask to speak to Sue Foster today. Do we need to be concerned about good control at last test? (when > 12 hrs since last dose trilostane)--- 09/02/2026 09:41:38 BRR:Lj spoke to pathologist and he confirmed ACTH stim must be conducted 4 hours after meds were administered. Patient to change to a morning schedule.--- 09/02/2026 2:22:16 PM BJ:Spoke with Sue Foster.Because clinically well, leave dose as is.Will have tonight off trilostane & start morning dose of trilostane tomorrow.Give usual dose in the morning with food. Book for ACTH stim test in 2 wksIF inappetant at all tomorrow morning, then give a dose of Cortate & drop trilostane to 100mg SID.(and book ACTH stim in 2wks) Called Renee & discussed as above.Will just do Proheart today.Can do vacc in 2wks with ACTH stim test Hospital Admission Consent FormPlease list any prescribed medications your pet is currently taking and when they were last given.: Trilostane 7pmReason for admission and planned treatment, diagnostic testing and/or monitoring : ACTH stim test and C5 and SR12Phone: 0407 268 871Is this the preferred contact number? If not, please complete below: NoSecondary contact phone number: 4658 0632 workEstimate: : $876.90View full form at https://api.vetcheck.it/share/AU_1271dd6b-336f-46cb-b069-f13d229b7f9e--- 10/02/2026 7:51:56 PM BJ:Called Renee for updateEating ok, just not as interested in the dry food. Eating wet food & treats fine.Seems ok in all other aspects.Has started trilostane dose in the mornings.Do ACTH stim test in 2 wks. Contact us if unwell--- 23/02/2026 10:25:19 AM CC :Tanya O called and said that Ally vomited in the early hours of the morning. O had not given medication. Gave "emergency medicine" (Cortate) and called us as directed. Advised BJ of this.--- 23/02/2026 1:48:52 PM BJ:Spoke with Renee. O woke up to Ally vomiting this morning.Gave Cortate 5mg tab.Usu Ally wouldn't eat after vomiting, but whe was interested so gave her some boiled rice.Has seemed ok since.In retrospect been fussy with her dry food for the past week; will eat it if o adds wet food (but has been leaving a bit of it behind); this is unusual for Ally who has always had a great appetite.Suspect maybe cortisol getting too low?Left message with Sue Foster from Vetnostics to call me back on how to proceed--- 23/02/2026 3:57:58 PM BJ:Sue F suggested stay off trilostane until 100% ok. Give more Cortate if lethargic or GI signs.Want her to be as eating as well as she used to; is she used to finish all her kibble, then wait until eats all her kibble again.Then resume at half the dose, ie 60mg = 0.6ml SID. If ok on this, then do ACTH stim test in 2 wks.Needs to be off Cortate 8 (preferably 12 hrs) b4 do ACTH stim test--- 23/02/2026 5:16:39 PM BJ:Called Renee and discussed as above. Ally has occas not finished her kibble, but not consistently not finished all her kibble for > 1 week now. Have to assume this is significant for her & could be related to her trilostane dosing. Once back to normal, drop trilostane dose by 50%    Vital Signs    Weight: 10.2;       Temperature: 38.8;       HeartRate: 124 ;