C10016148 / invoice 10000

urine brought in last night. Dipstick done but slides chucked out. Kept in fridge for this morning.

Urinalysis 
Collection method: free catch
Colour: yellow 
USG : 1.049
pH : 8.5
Protein : ++++
Blood : large
Glucose : neg
Ketones : neg
Bilirubin : neg
Sediment : yes 
low nos of struvite crystals on unstained slide
low nos of rods and occ chains of large cocci, very few neutrophils.
Assessment: well conc, very alkaline urine with bacturia and low grade crystalluria and pyuria
Plan: I suspect Stormi may have some urinary retention secondary to her pediculectomy
she has had several courses of amoxyclav and marboflaxacin with persistence - recommend C and S with a fresh sample.
start cystopro in the meantime.
Owner contacted with results: yes - discussed post sx incontinence - leaking urine with any activity or excitement - likely some urinary retention and overflow
Ree using dog wipes - moisturising rather than antibacterial
disp a pot of chlorhexadine wipes.
start cystopro capsules daily
spk to AVC re incontinence to see if we can trial something to help with a lower motor neuron bladder - bethanochol, prazosin but both may have side effects
discuss with Ree

Review physio 5 months post op. 

S/
UTI 1 week ago. 1/2 way through course of AB. 
Some incontinence if excited (bladder), sometimes some poos on bed. 

Walking: 
can still see flavoring
Sprints up and down fence lots
10-min walk 

O/
Gait: continues to hop on lead and in clinic room if allowed. Slowing walk right down ensures Stormi walks evenly through HLs
Full ROM HLs
No palpable discomfort throughout spine
Unable to 3-point stand on flat surface

A/
Primary issue- needs gait re-education, inc load on L HL as tends to fall to this side. HL and core weakness

R/
Lots of education today about walking, keeping slow
Exercises updated - minimal change
Walking:
Continue 10 minute walks x 2 a day. Keep really
slow - make sure no hopping. Uphill is great for hind
limb strengthening.
Sit and stands 2 x 10
Front legs on step- hold 3 x 1 minute hold

P/
r/v monthly
GC