C10008576 / invoice 10000

Reason: Prot/Creat Ratio Vetnostics1. VITAMIN B12:  161 pmol/L (186 - 670 pmol/L)Published canine reference interval from The Gastrointestinal Lab, Texas A&M University.Had 6x weekly 0.6ml vit B12 injection and now his second Vit B12 0.6ml every 2 weeks and is still low2. URINE PROTEIN:CREATININE RATIO = ***807***    Creatinine: 149 umol/LProtein: 1353 mg/dLThe low creatinine concentration and the markedly elevated urine protein creatinine ratio are not consistent with urine and suggest that this sample is fluid from around the bladder. Cytology will be addedWhen sampling the small bladder it appeared turbid and uncertain if it was from the bladder or from free abdominal fluid???Performing a cytology on the fluid sample:CYTOLOGY:  FLUIDCLINICAL NOTESFluid from around the bladder.SPECIMEN RECEIVEDLess than 1 mL of pale pink and nonviscous fluid with debris.MICROSCOPIC EXAMINATION    Cell count:    0.2 x 10^9/L     Protein:       10 g/L    SG:            1.016    Insufficient cells for differential count.    Gram Stain:   Negative.The direct smears are poorly cellular. The cytospin preparation (25 uL) is poorly cellular with a colourless background containing occasional erythrocytes. Nondegenerate neutrophils predominate. There are also scattered large mononuclear cells and rare lymphocytes. No neoplastic cells or infectious agents are identified.INTERPRETATIONTransudate.COMMENTThe fluid is a bland transudate with no evidence of inflammation or exfoliating neoplasia. The relatively low creatinine concentration of the fluid rules out uroabdomen.    Vital Signs    

Urine results. Requested Culure. Culture added JS BG. And Silvana forwarded to SSR    Vital Signs    

Reason: B12 Inj + Cysto UrineHistory: Urinated in the car on the way to MLIVC.Eating ok and not putting on weight.Urinating in the house which is uncharacteristicResponded well to 4 weeks of clavulox abs for an Ecoli UTI previously treated by Dr Scot READ.Examine: Thin body condition and not putting on weight.Hydration ok and underweightPlan: Admit for vitB12 bloods and gave vitB12 0.6ml s/cCollect urine for Urinalysis and U P:Cr ratio.U/S guided urine collection but uncertain if it was urine as the bladder was small and poss free fluid in the abdomen.Unusual opacity in the bladder and likely oval opacity just cranial to the bladder and uncertain if enlarged prostate?One stage the possible bladder appeared to have turbid fluid and not classic lucency on ultrasound.Have advised vetnostics to perform fluid cytology if they think that it is not urine?Offered prostate exam but owner happy to wait for referral for U/S etc....Sent referral to Animalius Vet Medicine Dept.Laboratory: UrinalysisLeuc/RBC/epith >200cells, no cast/crystals,SG 1.016, pH 7.5, prot 3+, blood 3+, gluc trace, ket neg, bili neg.Left message and will request urine C&S with vetnostics (Bruna will request via email).Will likley require further abs and workup    Vital Signs