C10011165 / invoice 10000

10/03/2026 Reason: Recheck

History:
Jinniu stopped having blood in urine since starting amoxyclav, but blood in urine resumed shortly after medication has stopped
O says is certain blood is coming from urine rather than vulva as he sees pink tinges on the puppy pad and sitting in the urine
Otherwise Jinniu is well - EDD well, no CVSD

Vital Signs:
Temperature:  39.2C
Heart Rate: 128  bpm 
Pulse rate:  128
Pulse character: strong and synchronous. 
Respiration Rate: .24 
MM: pink, moist
CRT: <1 sec

Dehydration assessment: Euhydrated MM moist no skin tent

PHYSICAL EXAMINATION:
Appearance: BAR; BCS 4/9
Eyes: nad. no redness, discharge, blepharospasm. responds to visual stimulus
Ears: nad. no debris or inflammation
Nose: nad
Oral Cavity: nad. mild tartar
Cardiovascular: Auscultation no murmur detected ,pulse quality normal ,rhythm regular
Respiratory: RE normal , auscultation normal
Abdomen: soft and comfortable, no discomfort on palpation
Musculoskeletal: ambulatory all 4 limbs
Neurological: appropriate mentation
Integument: free of ectoparasites or other skin lesion
Peripheral LNs:Normal size, symmetrical
Urogenital: bladder very small
Rectal exam:  not performed

Assessment/Problem List:
1. Hematuria
2. Borderline pyrexia vs. stress
DDx: UTI vs. bladder stone vs. cystitis vs. blood from reproductive tract given hx of recent puppies - vaginitis/pyo vs. other

Treatment:
Attempted bladder u/s and UA however no urine in bladder, practically empty and unable to visualise, no sign of pyo seem
Hold off on culture for now as abx has already been dispensed

Plan:
Amoxyclav 200mg 1/2 tab PO BID x5 dispensed in the mean time 
Meloxicam 0.3ml PO SID with food x3-5d for inflammation and pain relief
Urine jar for O to collect first urine of the morning and drop off for Sedivue + UA + USG ($140). Recommend to book for bladder u/s morning appointment before going on wee walk