C10017745 / invoice 10000

Chronological Previous historyAbnormal signs started on 21/8/25 where he seemed to have gone blind (looked left/right then fell off the bed), herecovered from this and had his eyes assessed by ophthalmologist and no ocular abnormalities were detected. Onexamination by the referring vet prior to referral the cat was noted to have absent menace and corneal reflex butpresent PLR.27/9/25 Presented for recurrent hematuria & signs of cystitis. Cat has high level of anxiety, he used to be on Fluoxetinebut it is bitter and poorly tolerated, is now on clomipramine. Free catch sample obtained and there was crystals, RBCsand occasional bacterial. Given buprnoephine & gabapentin at this time. Had had one vomit. Multiple episodes ofcystitis had been noted in the years prior to this event also3/10/25 had ultrasound for kidneys, got cysto sample of urine cocci present, did abdo rads. Given meloxicam. StartedClavuox drops 1ml BID and continued on gabapentin.5/10/25 presented for constipation, had also had reduced appetite at that time. Microlax given under sedation & laxapetat home. Failed to defecate at home.7/10/25 for urinary issues. Temp was 39.1. Hyporexic at this consult. Repeated rads and confirmed continuedconstipation. At this time normal proprioception but reluctance to walk. More microlax given & Actilac 2mls given POduring consult.8/10/25 presented for constipation. Continued lethargy, not moving at all. Appetite is reduced. Temperature was 39.2at this consult. Fully weight bearing. Had A GA enema with no complications. repeat x-rays showed efficacious. Hadeaten better the next day but still not walking.9/10/25 still not walking, can stand but will not walk. Eating and drinking ok.10/10/25 Urinating on himself as not wanting to move. Stands with left paw externally rotated. Presented in lateralrecumbency. Hunched over back and neck down. Delayed proprioception in hind paws. Temperature 38.2. referred tous at SASH. Given 0.11mls of methadone SQ before transfer.Further evaluation at SASH included in house CBC/biochemistry, MRI, CSF analysis, FIV/FeLV, IMMY cryptococcal antigen and toxoplasma ALL negative. SASH cardiology show no evidence of heart causing sycopal episodes. Owner presents here with no cat, just to discuss plan: has a siezure episode every 2 weeks.Pre-ictal phase: circles, spaces out, goes for quite a long period minutes to 1hrMedications now: Phenomav 1/4 of 30mg tablet PM ONCE DAILY Started @ 1/2 tablet AM PM, wasnt moving > 2month > every 2 weeks has these episodes still. Owner reports is "normal self" in between episodes. But is generally a quiet cat. eating ok, drinking Ok, urinating ok, defecating OK. A: idiopathic epilepsy is most likely given negative MRI scans, FIV FELV CSF wnl, neg toxo titres, crypto immy tests, corona PCR, pre-post prandial bile acids, magensiums, ammonia all within normal. (no seen corona PCR ) continued siezuring (dx innapropriate medication regime + dose vs other less common disease, degeneration.. rare dz) P; Suggest internal referral to discuss case with MG, as either adjust medications ie + keppra ect... or repeat central disease workup hoping to find something different which I dont think would yeild a different outcome, but owners qustioning this. Owner will book in in the next week to get trough phenobarbitone levels tested to know at least if phenobarb levels are within therapetuic normals and still having breaktrhough seizuring. repeat full CATP at same time. Likely need sedation as apparently ver cranky.