C10008177 / invoice 10000

Species:CANINE
Breed:Chihuahua
Age (years):2
Diagnosis or signs:Check up
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><p>History:<br>Chronic cough/respiratory noise since adoption - described as whole body effort with stomach breathing in. Occurs mainly when excited (e.g., owner returns home, visitors), occasionally at night waking from sleep, and rarely spontaneously while resting. Cannot wear collar as triggers episodes. Video shows mild episode. Occasional hip-skip/limping noticed - grade 1-2 patella luxation previously diagnosed. Episodes were frequent when younger, decreased around March of last year, but owner reports increasing frequency recently. Observes one leg doing slight bend when running. Plays and wrestles frequently with miniature dachshund in household.</p>
<p>Current medications:<br>Anxiety medication (type to be confirmed from records)</p>
<p>Examination - <br>FAS score: Anxious/trembling initially, calmed during consult<br>Behaviour: BAR<br>Neurological: Proprioception and mentation normal<br>Eyes: Open, comfortable, no discharge<br>Ears: Clean, no discharge<br>Teeth: <br>PLN: No lymphadenopathy<br>Respiratory: Normal bronchovesicular sounds, no heart murmur or arrhythmia detected on auscultation<br>Cardiovascular: MM pink, moist CRT &lt;2s, Heart regular rhythm<br>Abdomen: relaxed, soft and comfortable, no masses palpable<br>Integument: clean skin, no lesions visible<br>Musculoskeletal: Grade 2-3 bilateral medial patella luxation (not manipulated today to minimize stress)<br>BCS: <br>Urogenital: external appearance normal<br>Temp:</p>
<p>Differential diagnosis:<br>1. Paroxysmal respiration/reverse sneezing - likely given breed predisposition and episode characteristics<br>2. Brachycephalic airway syndrome - elongated soft palate possible despite nose length<br>3. Upper airway irritation/obstruction<br>4. Tracheal abnormality<br>5. Lower respiratory disease<br>6. Progressive patella luxation with developing osteoarthritis</p>
<p>Laboratory:<br>Pre-anaesthetic blood panel optional (previous results from desexing to be reviewed)<br>Cardiac troponin discussed but not recommended at this time given no murmur/arrhythmia/clinical signs</p>
<p>Diagnostic imaging:<br>Scheduled for Monday 08:20 - sedated thoracic radiographs (3 views on inspiration and expiration to assess tracheal dynamics and lung fields), bilateral stifle radiographs (lateral views each side plus single patellar tracking view to assess alignment and patella position)</p>
<p>Treatment:<br>Anxiolytic to be administered morning of procedure (type TBC based on current medication review)</p>
<p>Plan:<br>- Sedated chest X-rays (dynamic series) and bilateral stifle X-rays Monday 08:20<br>- Upper airway examination under sedation<br>- Assess patella alignment, positioning, and joint changes<br>- Establish baseline imaging for both respiratory and orthopaedic issues<br>- Determine if patella luxation surgical correction indicated (currently grade 2-3)<br>- Pre-anaesthetic blood panel offered as optional<br>- Estimate to be emailed<br>- Gap-only payment available through pet insurance</p></html>

Animal clinical history (3 most recent)

2025-11-11T00:00:00Z 16:35:00
Insurance - Primary Diagnosis/suspected diagnosis/location:Suspect cause:Any other conditions being treated (if any):Known health concerns:Date of first clinical signs (if known):History: Still shaking head a bitCurrent medications: has been on PMPExamination -TPR: still mil discharge, no inflammation in canal, TM okLaboratory: clear invueTreatment: continue PMP for another 3 days, then switch to HCA/cortavance
2025-11-04T00:00:00Z 15:56:00
Insurance - Primary Diagnosis/suspected diagnosis/location:Suspect cause:Any other conditions being treated (if any):Known health concerns:Date of first clinical signs (if known):History:Flea/tick/worming /heartworm prevention:Current medications:Diet:Examination -FAS score:Behaviour:Neurological: Proprioception and mentation normalEyes: Open, comfortable, no dischargeEars: Clean, no dischargeTeeth: PLN: No lymphadenopathyRespiratory: Normal bronchovesicular soundsCardiovascular: MM pink, moist CRT <2s, Heart regular rhythmAbdomen: relaxed, soft and comfortable, no masses palpableIntegument: clean skin, no lesions visibleMusculoskeletal: No pain or lamenessBCS:Urogenital: external appearance normalTemp:Discussion:Laboratory: Imaging:Differential diagnosis:Treatment:Plan:
2025-06-27T00:00:00Z 12:40:56
Examination Text:Reason: C5 Vacc History:EDDU normally, no other concerns, was booked for MPL surgery but O hasnt noticed any issues with it for months so monitoring for now, felt perhaps improved with age. Flea/tick/worming /heartworm prevention: UTD Examination: Behaviour: BAR FAS 4-5 (frozen, terrified, wont take treats, looked like would bite a couple times) - better away from O and with towel over head relaxed. Not good on the ground, slipped lead and ran away. Needs PVPs Neurological: Proprioception and mentation normal Eyes: Open, comfortable, no dischargeEars: Clean, no dischargeTeeth: 0/4PLN: No lymphadenopathyRespiratory: Normal bronchovesicular soundsCardiovascular: MM pink, moist CRT <2s, Heart regular rhythm Abdomen: relaxed, soft and comfortable, no masses palpableIntegument: no lesionsMusculoskeletal: No pain or lameness, grade 1 MPL bilateral, can manually luxate but not sponanteously luxating BCS: 4/9Urogenital: external appearance normalDiagnosis: Fit for vacc Treatment: C4 protech + BB vacc Plan: Booster C5 in a year

Previous claim history (12)

DateClaim #Diagnosis
2025-11-11C9476828OTITIS EXTERNA
2025-11-04C9445184OTITIS EXTERNA
2025-06-27C8895073BEHAVIOUR DISORDER
2024-12-20C8103507CRYPTORCHID
2024-11-28C8005746CRYPTORCHID
2024-11-21C7976279CRYPTORCHID
2024-11-18C7961853CRYPTORCHID
2024-11-06C7911725EAR INFECTION
2024-10-30C7884769EAR CONDITIONS
2024-10-17C7884624EAR INFECTION
2024-09-03C7884605ABSCESS
2024-05-08C7884586VACCINATIONS OR HEALTH CHECKS

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_consultation99.002026-03-10

UPM+

  • DG01268PATELLA LUXATIONDSTP_patella_luxation

Variant (sleepy_king)

PATELLA LUXATION
DSTP_patella_luxation
Conf: 0.560
Threshold: 0.72
Above:
Correct?