C10017593 / invoice 10000

Reason: RV Seizures CCSEAppointment Notes: has had 2x in the past 2 weeks and they are becoming worsepatient EDUD normallyrescheduled from 09/09 CCSEHistory:C/O seizure activity. Cash has had three seizures in total. The first occurred approximately two months ago. The last two seizures occurred 2.5 weeks apart, indicating an increasing frequency. The seizures last for approximately one minute. The most recent seizure occurred at 0230, presenting with head swaying, which resolved following intranasal diazepam administration. The post-ictal phase is characterised by disorientation for approximately five minutes, followed by a return to normal behaviour. A prodromal phase of 1-2/7 is reported, where Cash becomes withdrawn and stressed. There is also a history of episodes of tongue spasms/lip smacking for the last couple of years, which may represent focal seizures. Owner reports a wheezing noise when Cash is picked up or resting comfortably. No V+ or D+.Examination:EEN: No discharges, swellings, or exudates noted. PLR positive both eyes Dental score: not assessed Lymph Nodes: Peripheral lymph nodes are symmetrical and WNL.Heart: No murmur or arrhythmia detected, pulses strong and synchronous.Chest: Bronchovesicular sounds are clear, no crackles or wheezes auscultated.Integument: Knots in the coat were clipped. A new patch of grey fur around the muzzle was noted by the owner post-last seizure. No other lesions, parasites, lumps, or masses found.Abdominal palpation: Abdomen is soft, non-painful, with no organomegaly detected.Neuro: Mentation is bright, alert, and responsive. Gait is normal with no deficits observed.Assessment:Suspected idiopathic epilepsy based on signalment, history, and normal physical examination. The increasing frequency of generalised seizures is noted. Focal seizures are also suspected.Other ddx Neospora vs cryptococcus vs hepatoencephalopathy vs other causes Treatment:- Dispensed pre-filled syringes of Midazolam for intranasal or rectal administration during seizure events.- Discussed referral to a veterinary neurologist at ARH or VSS for specialist consultation and further diagnostics (e.g., spinal tap, CT scan) to rule out other causes of seizures before commencing long-term anti-epileptic medication.- Advised on seizure management at home: remain calm, ensure a safe/dark/quiet environment, avoid stimulation (touching, talking), and video record episodes for future assessment. Provided details for ARH and VSS.--- 11/09/2025 09:24:45 AM SN8:Examinations - Resolved -    Vital Signs    Weight: 4.6;       HeartRate: 130;       BodyScore: 6;