C10010519 / invoice 10000

Reviewer

Species:CANINE

Breed:Bichon Frise Cross

Age (years):13

Diagnosis or signs:ACTh stim test results

Consult notes

<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div>
<div>
<div>
<div>
<p>Pre 256 nmol/L<br>Post 330 nmol/L (&gt;300 =cushings on new testing)<br><br>New parameters/methodolgy<br><br>Will discuss with internal medicine person the new type of results<br><br>Polyphagia nighttimes<br>Elevated liver enzymes<br>Potty abdomen<br>Chronic skin<br>Previous + LDDS test<br>strong reaction to standard starting  dose of trilostine 2 years ago, rec to drop by 20%, <br><br>Spoke to kathleen<br>Advise of result, that I would recheck methodology with lab etc and get back to her<br>On 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 night<br><br>Spoke to pathologist<br><br>Will recommend starting low dose trilsotine at 10mg sid<br>(previously 15mg daily divided or ~1mg/kg bid)<br>revist 3 weeks for modifed ACTh stim test 3-4 hours post dose</p>
</div>
</div>
</div>
</div></html>

Animal clinical history (3 most recent)

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

2026-03-02T00:00:00Z 08:37:00

Blood pressure on traz normalACTH stim test"0" bloods at 9.55am0.17ml synacten IV given at 10.02am" 1" bloods at 11.05amTeeth mobile 209>dental work required

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_cushings_disease_medication	90.00	2026-03-06	—
20000	tstarc_corticosteroids	31.50	2026-03-06	—

UPM+

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

Variant (sleepy_king)

HYPERADRENOCORTICISM ("CUSHING's")

DSTP_hyperadrenocorticism_(cushing's_disease)

Conf: 0.840

Threshold: 0.18

Above: ✓

Correct?

Yes No