C10008766 / invoice 10000

REASON - difficulty eating persist post dental 

O concerns
slow to eat
reduced appetite
eats 2/3 bowl then leaves this ( unusual for him) 
favours one side mouth ( avoids side he had extraction on ) 
oral pain ?
urination and defecation on floor - does this when stressed
only done in laudnry near litter  ( both urination and defecation in laundry but not in the litter)  - no urination and no defecation in trays
struggles with dry > moist

drooling non 
movement non 

no chnages at home 

cough non 
any better on pain relief> margial better on pain relief

** urination and fecation on floor when stress**
** hand readred cat**


Medical concer
FIC intermittently managed with melox fluox pregab diet
Anxiety - car - advise pregab for vet visit
Dental ( feb 26) with extns fcorl 203 and 307
Fur in stool


Medicatoins
fluox 0.5 ml ( 5 mg  ) sid - ongoing for > 24 m
pregab 50 mg/ ml 0.3 l before consult given 
bup ( dose )  NOT 
melox pnr fic  0.6 ml po daily for 5 days  ( limited improvement) 

Inside/ inside out inside only 
Single/ multip cat 2 cat house 1 dog 
No litter tray location type litter - 4 trays, clean daily, pine pellets ( has had entire life) , some covered and some not covered, diff sizes, all in laundry

food bowl in kitched


Diet Hills urinary dry and RC urinary wet  + water added to all 

Prev investigations
Feb 26 CBC PAP only
reti 76 aim < 50 
remainder NAD
nb no elyte Ca PO4 T4
SG 1022 ph 6.5 nad seds no UC

Vac
Dec 26 F2
Dec 27 F3

worm suggest 3 mo mil pro
tick flea sugges 3 mo bravecto


EXAM
wt 6.45 
Wt lost 500 gm in 6-7 mo 





Tx
TAHP UA
watch eat

PLAN
meds as above
does fluox? redice app
esoph disease?
behav consider location food bowl etc

Owner called and spoke to reception to advise Nigel still not eating normally - still very slow with food
Wondering if they can give some pain relief - has buprenorphine at home
Advised yes, but he should probably be rechecked by a vet asap as I am not sure why he is still not eating normally 
booked with RJ early next week

=========
owner called back to say they are finding it hard to get buprenorphine into him
ok'd trying meloxicam (which they have at home and use for FLUTD episodes ) providing he has it with a meal and has no GI upset 

Consultation nurse: RR

Reason for presentation: Dental recheck

History for today:
still eating a bit more slowly than usual but seems improved, eating slower. Unable to administer the buprenorphine.
Has had some urination and defection on the floor still - usually an indication that he is stressed about something
back on dry food now


Previous medical/surgical concerns:
11/02/2026 - Dental with extractions (203 & 307)
10/12/2025: Hungry on pregabalin.
08/2025: Hair in faeces - microlax.
23/07/2025: FIC flare up, treated with pregabalin.
01/2025: Ongoing FIC, treated with meloxicam, fluoxetine, pregabalin and diet change.
Chronic FIC.

Current medications:
Fluoxetine 0.5ml (5mg) daily
Pregabalin for vet visits - 0.2-0.3ml
Meloxicam 0.6mL SID used for FIC episodes.

Diet:

Examination:
BAR
mm pink 
ds 1
extraction sites appear well healed
gained a little weight

Assessment:
recovered well

Treatment:
none

Next vaccination due: 

Plan: monitor
discussed that FORLs are often symmetrical and may go on to develop more in future, monitor for changes in eating/behaviour
re house soiling, could consider a slight increase in fluoxetine if ongoing