C10005776 / invoice 10000

Have reminders been checked? Has the owner been advised of this? GapOnly claim Insurance SummaryFirst Clinic Signs: Two nights ago GAstro signs + Urinary signs today..Diagnosis/Suspected: Open for Gastros + Hx of Bladder stones and crystalsSummary/Suspected Cause:  Open - acute dehyd event prempting haematuria? other. UA no crystals or bacteria.Any other conditions being treated/known health concerns(if any): CAOX bladder stones with DietExisting Treatment/Plan: Running blood work. Need to r/c rectal to assess prostate, repeat UA and feed ONLY canned Urinary food.History:Blood coloured urine this morning.Two nights ago - V+ during the night, undigested kibble, bits of bark/stick content, and massive D+ a few bouts. Woke very lethargic but happy on walk. Ate two feed of kibble yesterday. Small amts but O happy.No more V no more d+.At the beach this morning - passed the bloody urine - HX of crystals two types. Has had stones removed. Prev vetPassed faeces yesterday a more normal faeces now.Fed canned food this morning.RC Urinary S/O - dry and wetBeef liver treat source (restricted)Some other human food sourcesDoes get babysat with Nan so could def get other food sources as wellPex:MM pink, CRT <2s. CV/Resp: heart auscultates clear, no murmur noted. Clear breath sounds in all lung fields on auscultation, normal effort.Ocular: Eyes clear, no discharge, no blepharospasm. Aural: Ears no discharge, no erythema, no odour. Nasal: No nasal discharge.Oral: DG2 - not fully examinedGI/UG: abdominal palpation - soft and no obvious abnormalities palpated, no obv stone palpableInteg: skin in good condition, no lesionsPLN: peripheral lymph nodes palpable < 1cmMSK: Ambulating without lameness.Attempted Rectal to check prostate and palp for stones but large formed faeces present Prob List: HaematuriaGastroenteritis resolvedLab:UA Test 05/03/266:12 PMKetones - 0 mmol/LBilirubin - 0 umol/LProtein +1 0.3 g/LGlucose - 0 mmol/LBlood +3 200 Cell/uLpH 7.5USG 1.032Blood CellsRBC >100 / HPFWBC <5 / HPFBacteriaCocci None to RareRods None to RareCastsHyaline Cast <1 / LPFNon-Hyaline Cast <1 / LPFCrystalsStruvite <1 / HPFCalcium Oxalate Dihydrate <1 / HPFBilirubin <0.1 / HPFCystine <0.1 / HPFAmmonium Biurate <0.1 / HPFAssessment:Haematuria- UA more concentrated than ideal for CaOx, but sediment no detactable crystals or bact on this sample, RBC 3+TAHPALB 43 g/L 25 - 44ALP 74 U/L 20 - 150ALT 30 U/L 10 - 118AMY 583 U/L 200 - 1200TBIL 5 umol/L 2 - 10BUN 5.7 mmol/L 2.5 - 8.9CA 2.89 mmol/L 2.15 - 2.95PHOS 1.21 mmol/L 0.94 - 2.13CRE 78 umol/L 27 - 124GLU 6.2 * mmol/L 3.3 - 6.1 HighNA+ 150 mmol/L 138 - 160K+ 3.5 * mmol/L 3.7 - 5.8 LowTP 71 g/L 54 - 82GLOB 28 g/L 23 - 52 RBC 6.4 10^12/L 5.7 - 8.7HGB 142 g/L 123 - 200HCT 45.8 % 36.7 - 59.6MCV 71.9 fL 61.2 - 73.6MCH 22.3 pg 18.9 - 26.4MCHC 323 g/L 301 - 388RDW 12.9 % 11.8 - 13.9WBC 15.7 10^9/L 4 - 14.1 HighNEU% 81.6 % 0 - 100LYM% 13.5 % 0 - 100MON% 2.6 % 0 - 100EOS% 2.3 % 0 - 100BAS% 0 % 0 - 100NEU# 12.8 10^9/L 2.3 - 9.8 HighLYM# 2.1 10^9/L 0.7 - 3.7MON# 0.4 10^9/L 0 - 0.4 HighEOS# 0.4 10^9/L 0 - 0.8BAS# 0 10^9/LPLT 360 10^9/L 121.6 - 440.6MPV 14.5 fL 9.5 - 13.6 HighRTC% 0.3 %RTC# 21.9 10^9/L 0 - 100Inflam Leukogram - stress vs systemic inflam, mildPlan:  ? Did discuss whether the acute gastroenteritis has triggered the event, short dehyd event....O consents to TAHPDiscussed no crystals or bacteria in this sample, just blood. Doesnt rule out prostate or bladder stone, or that another urine sample could reveal moreDiscussed repeat UA sampling - O will bring in another sample to reassessDiscussed rectal to check prostate - O happy to come in for r/c of this, At this stage feed Urinary wet exclusively and encourage water consumptionCall w blood results. DIscussed abdo US may be indicated as well.Called O w blood results and discussed - plan stays the same. DO repeat UA, repeat rectal and feed canned urinary for the weekend. O aware of SASH if anything changes. Email O hx incase.

Have reminders been checked? YHas the owner been advised of this? VaxGapOnly claim Insurance SummaryFirst Clinic Signs: N/A - vaccination and health checkDiagnosis/Suspected: N/A - vaccination and health checkSummary/Suspected Cause: - vaccination and health checkAny other conditions being treated/known health concerns(if any): nilTreatment/Plan: Given C5 SQHx:On urinary food (wet and dry)Not on any medicationsUTD NGSEDDU wellHas a sensitive stomach, is a bit of a scavengerPEx:BAR, mm pk+m crt<2sec. EEN wnl. Very mild calculus upper canines.Cardiac ausc wnl. Lung sounds clear. Abdominal palpation soft and comfortable. Ambulating well. WBx4. LNs wnl.A little overweightTx: Given C5 SQPlan:C5 due 12mthReduce food by 5%  -aim for weight of 9.5-10kg

Have reminders been checked? YHas the owner been advised of this? YHx: Darker hair on back started growing in 6-8 weeks ago. Initaly rough but now softened. Not itchy or bothered by the spot. In the last week O feels like loosing balance more and after jumping off the bed has slipped walking around the corner multiple times in the last few days. Yesterday when O was throwing ball to him kept missing and getting hit in the face. Otherwise BAR and doing well. EDDU well and no coughing, sneezing, vomiting or diarrhoea. Diet: RC urinary + treats (beef liver) + wet + probiotic Prop: NGS (monthly)Meds: None Exam:Eyes/ears: No discharge noted. Eyes clear. Normal menace and PLR. Able to follow a dropped cotton ball. Oral: MM pink and moist. Minimal build up present. Cardioresp: No murmur or arrhythmia. Lung sounds clear.Integ: Coat in good condition. Discoloured patch of hair along the caudal aspect of the dorsal spine. MSK: Ambulating well, no pain on joint palpation, good range of motion. Normal proprioception. Comfortable on spinal pressure. Question if tense on range of motion of neck to the left and down. Plan: DDx: Soft tissue trauma vs behavioural vs IVDD vs meningitis vs neoplasia vs other Discussed with O suspect slight neck pain and may be cause of signs at home. Will trial on pain relief and if not improving or getting worse to bring back for reassessment. If O can gets videos will also be helpful. Dispensed meloxicam SID for 3-5 days. Discussed with O suspect change in hair colour due to trauma and O mentioned runs under bed to hide a lot and drags this section of back under bed. Skin not irritated and likely not to grow back to normal colour. O to monitor and if getting worse to bring back for recheck.