C10014892 / invoice 10000

Species:CANINE
Breed:Labrador
Age (years):12
Diagnosis or signs:Ultrasound
Consult notes
10/03/2026 CL ultrasound of abdo:
-seemed v uncomfortable in dorsal recumbency so given butorphanol iv-mild effect (some sedation, min pain relief)
-Right kidney-large mass causing hydronephrosis as blocking ureter, extends into retroperitoneal space (9.4cm x 6.7cm with caudal extension, cf left kidney normal sized 6.9cm x 3.4cm) )
                     -v vascular, mineralised, extends towards trigone, hydroureter at pelvis 1.5cm (shouldn't be able to see this hardly) 
No free fluid
Rest of exam NAD

Ddx-haemangiosarcoma v renal carcinoma

If wanting to investigate further consider urine, chest xrays, CT, referral
Regardless needs pain relief. Start with gaba, panadol +/- mirtazepine

Tx-gabapentin 300mg tid (start sid, bid, tid)
-panadol 375mg-500mg bid
-mirtazepine 

STO-this has come as quite a shock, she will discuss with family how long they want to try and treat her for, meantime will see if we can provide pain relief and improve appetite

Animal clinical history (3 most recent)

2026-03-10T00:00:00Z 12:35:39
CL ultrasound of abdo:
-seemed v uncomfortable in dorsal recumbency so given butorphanol iv-mild effect (some sedation, min pain relief)
-Right kidney-large mass causing hydronephrosis as blocking ureter, extends into retroperitoneal space (9.4cm x 6.7cm with caudal extension, cf left kidney normal sized 6.9cm x 3.4cm) )
                     -v vascular, mineralised, extends towards trigone, hydroureter at pelvis 1.5cm (shouldn't be able to see this hardly) 
No free fluid
Rest of exam NAD

Ddx-haemangiosarcoma v renal carcinoma

If wanting to investigate further consider urine, chest xrays, CT, referral
Regardless needs pain relief. Start with gaba, panadol +/- mirtazepine

Tx-gabapentin 300mg tid (start sid, bid, tid)
-panadol 375mg-500mg bid
-mirtazepine 

STO-this has come as quite a shock, she will discuss with family how long they want to try and treat her for, meantime will see if we can provide pain relief and improve appetite
2026-03-09T00:00:00Z 12:07:30
STO- dog is stable. o happy to wait for abd ultrasound to be done tomorrow. we will start from abd ultrasound and see if chest xrays are needed. o is probably not very keen on doing splenectomy because of the dog's age. both owners are medical doctors. sounds like they just want to confirm and support her with palliative treatment- gaba/panadol/tranexamic acid...etc

Previous claim history (12)

DateClaim #Diagnosis
2026-03-08C10004730INAPPETANCE
2026-01-19C09792345VACCINATIONS OR HEALTH CHECKS
2024-12-24C8120882EAR (AURAL) DISEASE
2024-12-24C8120882VACCINATIONS OR HEALTH CHECKS
2024-03-25C7041406INTOXICATION (POISONING) - THEOBROMINE/CHOCOLATE
2024-03-25C7048052INTOXICATION (POISONING) - THEOBROMINE/CHOCOLATE
2021-11-14C4252120VACCINATIONS OR HEALTH CHECKS
2019-11-30C2582111VACCINATIONS OR HEALTH CHECKS
2017-10-25C1408702VACCINATIONS OR HEALTH CHECKS
2017-10-25C1408702FLEA/TICK/WORM CONTROL
2017-10-25C1408702FLEA/TICK/WORM CONTROL
2014-05-23C0293709FOOD ENGORGMENT

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

LinetstarcAmountDateUpstream diagnosis
10000tstarc_hospitalisation61.952026-03-10
20000tstarc_procedure_fee_-_ultrasound529.002026-03-10
30000tstarc_iv_catheterisation42.902026-03-10
40000tstarc_procedure_fee_-_ultrasound73.002026-03-10
50000tstarc_opioids_-_butorphanol76.552026-03-10
60000tstarc_mirtazapine43.502026-03-10
70000tstarc_anticonvulsant_medication_-_gabapentin86.752026-03-10

UPM+

  • DG02649MASS LESION - ABDOMINALDSTP_mass_lesion_-_abdominal_(other)

Variant (sleepy_king)

MASS LESION - SPLENIC
DSTP_mass_lesion_-_splenic
Conf: 0.160
Threshold: 0.90
Above:
Correct?
Acceptable?
Reason (not acceptable — misleading)
Diagnosis description