C10004597 / invoice 10000

Reason: Abdo Us AdmitHistory: Urinates more than he used to - not sure if volume related or just because urinating inside because of mobility issues. Eating normally, drinking normally.Wants us to check teeth when sedated. Examine: Limited exam. Chest auscultation NSFs. Very anxious.Owner Called / Discharge Time: --- 09/03/2026 14:25:42 AWM:Called owner, confirmed discharge @ 3pmAnaesthesia: Sedated 0.3mg/kg butorphanol IM. Still v anxious so given 10mcg/kg medetomidine. Nice sedation to facilitate IV placement. Will need top up before ultrasound.Gave 2mcg/kg medetomidine IV + 0.1mg/kg butorphanol IV 12pm. Alfaxan slow IV to effect.Ultrasonography: MILN (max thickness 5-8mm) = NSFsBladder  = NSFsProstate = NSFs, 1.6cm x 0.84cmLeft Kidney  = NSFsRight Kidney = NSFsLeft Adrenal (<10kg = < 0.54cm , 10-30kg = <0.68cm ,  >30kg = <0.8cm) caudal pole 3.4-5.3mm, cranial pole 3.5mm Right Adrenal (<10kg = < 0.54cm , 10-30kg = <0.68cm ,  >30kg = <0.8cm) Caudal pole 4.5mm Spleen = NSFsStomach (shouldnt exceed 5mm)  = 3.3mmPancreas - generalised increase in echogenicity of pancreas, irregular and subjectively swollen Liver = NSFsGall Bladder = non-dependent sludge, wall 0.5mm and normal echogenicity, could not visualise common bile duct, fusiform shape, mildly dilated R MILN 2.6mmL MILN unable to visualiseDuodenum 3.4mm, 4.2mm  <15kg thickness shouldn't exceed 3.8mm15-30kg thickness shouldn't exceed 4.1mm> 30kg thickness shouldn't exceed 4.4mmJejunem 2.6mm, 2.7mm <15kg thickness shouldn't exceed 3.0mm15-30kg thickness shouldn't exceed 3.5mm> 30kg thickness shouldn't exceed 3.8mmIleum 1.7mm <15kg thickness shouldn't exceed 3.0mm15-30kg thickness shouldn't exceed 3.5mm> 30kg thickness shouldn't exceed 3.8mmAbdominal Lymph Nodes - NSFsMax height (thickness) shouldn't exceed 5-8mm(pediatric dogs) - thickness shouldn't exceed 10mmAssessment: Changes suggestive of chronic pancreatitisNon-dependent GB sludge G1 dental dz on examinationPlan:V low fat diet - If O wishes to home cook can find recipe on VNGStart ursodiol 100mg SIDRecheck liver values and fasted trigs in 4-6 weeks    Vital Signs    Weight: 10.1;       

Reason: Get Bloods For TSH And B12History: O reports no changes/new concerns since last visit. Medication: gabapentin 100mg/trazodone 50mg PO last night/this morning (7.15am). Objective: Quiet, alert and responsive. Weight gain of 30 grams. Very anxious - only just able to collect blood sample today - trying to bite through the muzzle. Laboratory: 1ml serum to vetnostics for TSH & B12 Plan: Await bloods - ABK/KR to follow up mid next week. Would recommend gabapentin 200mg/trazodone 100mg prior to future venepuncture.    Vital Signs    Weight: 10.36;       

Reason: BloodsALT                              112*  U/L           (18-89)Alkaline Phosphatase             621*  U/L           (11-129)Protein                           73*  g/L           (53-72)Triglyceride                    13.5*  mmol/L        (0.2-1.7)Total T4                         < 9*  nmol/L        (13-47)Communication: ST Marina. GI signs are intermittentHard to know if any of the abnormalities are related to the blood changes or unrelated incidental findings. Consider adding B12 and TSH for now. Then consider abdo ultrasound and then poss ACTH stim to look into hyperA. Regardless of whether or not related - warranted to look into as need to decide on best treatment going forwards - nsaids vs paracetamol. O OK to add on extra tests. Will call tyomorrow to pay and put through insurance details. Warned may need more blood. --- 28/01/2026 13:06:08 KJR:LM for Marina to organise getting more bloods. Suggest 50mg traz/100mg gabapentin (1/2 chill pill) beforehand to allow to get bloods easier. --- 29/01/2026 10:07:22 KJR: ST Marina. Tremor still continuing. A few days of urination inside despite taking him outside. Big wees in the house no blood noted. No changes in the environment. Happy t o get booked in for tomorrow. Chill pill dispensed to collect later today. Bloods for TSH and B12 please O aware of $187 cost for each test. Shouldn't need additional health check unless O has more concerns tomorrow. Laboratory: VETNOSTICS    Hb      179  g/L        (129-201)      WBC     9.0  x10^9/L    (4.7-12.8)     RCC    7.0  x10^12/L    (5.7-8.3)       Neut   6.7  x10^9/L    (3.1-9.0)     Hct   0.46             (0.38-0.57)     Lymp   1.3  x10^9/L    (1.0-3.5)     MCV     66  fL         (63-75)         Mono   0.5  x10^9/L    (0.2-1.0)     MCH     26  pg         (22-27)         Eos    0.5  x10^9/L    (0.1-1.0)     MCHC   389* g/L        (328-378)       Baso   0.0  x10^9/L    (< 0.2)    Plat    235  x10^9/L     (150-539)    RET-He 22.8  pg         (21.3-28.1)    Red cells   : Lipaemia +.    White cells : Normal.    Platelets   : Normal.    Haemolysis + Manual PCV performed. Specimen lipaemic and haemolysed,    the red cell indices are unreliable/inaccurate, hence red cell comments    not possible.    Fasting status                Random    Sodium                           150   mmol/L        (145-152)    Potassium                        4.7   mmol/L        (4.3-5.9)    Chloride                         111   mmol/L        (100-120)    Bicarbonate                        7*  mmol/L        (16-25)    Anion Gap                         37*  mmol/L        (16-29)    Urea                             5.2   mmol/L        (3.0-9.8)    Creatinine                        84   umol/L        (50-127)    Serum Glucose                    3.2*  mmol/L        (3.6-6.2)    Bilirubin                          3   umol/L        (< 6)    AST                               60   U/L           (12-97)    ALT                              112*  U/L           (18-89)    GGT                              < 5   U/L           (< 7)    Alkaline Phosphatase             621*  U/L           (11-129)    Protein                           73*  g/L           (53-72)    Albumin                           43   g/L           (28-44)    Globulin                          30   g/L           (18-37)    Albumin/Globulin Ratio           1.4                 (0.8-2.3)    Calcium                         2.79   mmol/L        (1.87-2.83)    Phosphate                       1.32   mmol/L        (0.80-1.70)    Creatine Kinase                  330   U/L           (89-467)    Cholesterol                      7.3   mmol/L        (3.6-10)    Triglyceride                    13.5*  mmol/L        (0.2-1.7)    Haemolysis                       2+TOTAL T4   Total T4                         < 9*  nmol/L        (13-47)    Vital Signs