C10011562 / invoice 10000

Reason: Get Urine Sample For Big 3 + VitalsAppointment Notes: passed blood clott in urine. GN agreed because has CKD ideal for us to have nurse check her over CDLaboratory:  - free caught urine in the car park aproxx 3.00pm - kls SG - 1.014PH - 7PRO +ERY ++++BLO ++++Everything else WNL Wet prep - Dry prep -BP READINGS: 110, 105, 110, 105History:- Diet: Previously on raw and super herb but appetite decreased. Has been transitioning to Royal Canin Renal (tins and kibble) for the past week and is eating well.- Current medications: Probiotics and a seaweed additive in water for dental health.Examination:Mentation: Bright, alert, and responsive.BCS: 5/9Eyes: Grossly normalEars: Grossly normalMouth: MM pink and moist, grade 2/4 dental, CRT- Owner reports increasing tartar build-up, particularly on the upper canines.Nose: Grossly normalIntegument: Some rashiness and sensitivity noted on belly flaps. History of a blood blister on the back leg which has since resolved. History of rash and dry skin along the spine post-vaccination. Multiple skin tags present.CV: NAD on ausc in regards to rate, rhythm or soundsResp: No crackles or wheezes ausc in any field. Grossly normalAbo palp: No pain on palpation, no masses palpatedNails/feet: Grossly normalMusculoskeletal: Grossly normalLNs: No LN enlargement palpatedUrogenital: Grossly normalNeuro: Grossly normalAssessment:1. Chronic Kidney Disease (stage 2). Haematuria.2. Dental Disease.3. Dermatological issues (rash, sensitivity, skin tags).Treatment:1. POCUS (Point-of-care ultrasound) of bladder performed. Showed some bladder wall thickening, no obvious mass visualised. Attempted cystocentesis but bladder was too small to obtain a sample.2. N/A See Plan3. N/A See PlanPlan:1. Recheck for bloods taken on 23/01/2026 showed elevated urea and creatinine. In-house urinalysis today shows haematuria and pyuria, no bacteriuria seen on microscopy. Poorly concentrated urine. Advised owner that a UPC (Urine Protein:Creatinine ratio) test from January was not sent, and this has been removed from the invoice. To investigate haematuria and pyuria further, recommended a cystocentesis for urine culture and sensitivity, and a recheck of urine specific gravity (USG). Ivy to be admitted for the day tomorrow (11/03/2026) to allow for bladder to fill for sample collection.2. Discussed dental health. If a dental procedure is required in the future, it would carry a higher anaesthetic risk due to CKD. Pre-anaesthetic IV fluids for 24 hours would be recommended. Owner to continue with at-home dental care.3. Owner reports using Aloveen conditioner as a moisturiser for skin. Also reports insect bites cause significant local reactions. Discussed that a link between insect bites and haematuria is unlikely. Continue to monitor skin.    Vital Signs    Weight: 35.8;