C10007585 / invoice 10000

-----------------------------TRIAGE NURSE:Referring Veterinary Practice: Paddington Cat Ok to send Hx to rDVM: Yes History:She's diabetic and being managed for 3+ yearsBG last checked around 5:45pm: 4.7 Last insulin dose: 7:40am.On 4 units of Lantus 100IU/ml insulin BID. Not fed dinner yet. No PM insulin given yet tonight.On RC diabetic sachets (1 BID) + 1 tsp of FF grilled tuna flavour AM 1 capsule of metamucil to aid with stoolAll ok until 1.5hrs ago, walking around in circles, looked quite tentative (walking like perched), walking into corners and getting stuck, seems to not see O's hand when placed in front of her face, breathing fastNormally given 1 x 100mg capsule Gabapentin night before and 2-3 capsules 3 hours before the apptmt.Hyperthyroid as well. TT4 was last checked 9 Feb. Thyroid being managed with Carbimazole 10mg (1/4 tab BID with food). 27th Feb the insulin was placed in a freezer bag with an ice pack but O is concerned it may have lost its efficacy as had been out and about for awhile.Examine:BARMoving head from side to side in carrierIntermittent hissingNo nystagmus observedDilated pupils, no PLR, no menace response, no hyphema observedSpinal palpation non-reactiveAmbulatory but preferred to stay in carrierBP (systolic, tail base): 140, 120, 180, 160, 115Current problems:Acute vision lossAppears distressed but otherwise stable with appropriate mentationAssessment:Suspect hypertensive retinopathyClient Discussions: Discussed sedating for blood panel. However, Stephen was concerned that Tilly was overdue for her dinner and PM insulin dose.Recommended seeing an opthalmologist as soon as possible. Referred to SASH where they have an opthalmologist.    Vital Signs    MMColour: pink;       HeartRate: 160;       RespirationRate: 120;