C10010517 / invoice 10000

Reviewer

Species:CANINE

Breed:Bichon Frise Cross

Age (years):13

Diagnosis or signs:ACTH stim test

Consult notes

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<p>Blood pressure on traz normal<br><br>ACTH stim test<br><br>"0" bloods at 9.55am<br>0.17ml synacten IV given at 10.02am<br>" 1" bloods at 11.05am<br><br><br>Teeth mobile 209&gt;dental work required</p>
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Animal clinical history (3 most recent)

2026-03-05T00:00:00Z 17:40:00

Pre 256 nmol/LPost 330 nmol/L (>300 =cushings on new testing)New parameters/methodolgyWill discuss with internal medicine person the new type of resultsPolyphagia nighttimesElevated liver enzymesPotty abdomenChronic skinPrevious + LDDS teststrong reaction to standard starting  dose of trilostine 2 years ago, rec to drop by 20%, Spoke to kathleenAdvise of result, that I would recheck methodology with lab etc and get back to herOn clomipramine 7 days, no adverse effects, possible bit better, not scratching at door when left, able to be redirected to bed when pestering for food at nightSpoke to pathologistWill recommend starting low dose trilsotine at 10mg sid(previously 15mg daily divided or ~1mg/kg bid)revist 3 weeks for modifed ACTh stim test 3-4 hours post dose

2026-03-03T00:00:00Z 19:44:00

No ACTh stim results back as yetLMOM for Kathleen advising no results yet and will report on Thursday

2026-03-02T00:00:00Z 10:59:00

Doppler BP 10am, 110 SYS RF #3 cuff, 3x readings all consistently 110 SYS.ssm

Previous claim history (13)

Date	Claim #	Diagnosis
2026-02-04	C09853131	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2026-01-19	C09796349	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2026-01-19	C09796349	EAR (AURAL) ABNORMALITY - PRESENTING COMPLAINT
2026-01-12	C09745186	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2026-01-06	C09722021	BEHAVIOUR DISORDER
2026-01-06	C09722021	KERATOCONJUNCTIVITIS SICCA (KCS, DRY EYE)
2026-01-06	C09722021	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2015-02-22	C0472639	ANAL SAC IMPACTION
2015-02-19	C0472639	PATELLA LUXATION
2014-05-07	C0296140	ANAL SAC IMPACTION
2014-05-04	C0296140	PATELLA LUXATION
2014-05-04	C0296140	HERNIA - INGUINAL
2014-05-04	C0296140	ANAL SAC IMPACTION

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

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_diagnostic_test_-_acth_stimulation_test	300.33	2026-03-02	—
20000	tstarc_hospitalisation	65.00	2026-03-02	—
30000	tstarc_synacthen	95.00	2026-03-02	—

UPM+

DG02293HYPERADRENOCORTICISM ("CUSHING'S")DSTP_hyperadrenocorticism_(cushing's_disease)

Variant (sleepy_king)

HYPERADRENOCORTICISM ("CUSHING's")

DSTP_hyperadrenocorticism_(cushing's_disease)

Conf: 0.730

Threshold: 0.18

Above: ✓

Correct?

Yes No