C10021867 / invoice 10000

Sedated with butorphanol 0,1 ml and medetomidine 0.05 ml 100% indoor cat. parasite control Advocate once every 2 months FINDINGS:Urinary bladder: Bladder wall: 1.1 mmThe bladder contains a moderate volume of anechoic urine. The bladder wall is circumferentially within normal limits for thickness and architecture. There are some suspended echogenicities noted in the bladder. There is no evidence of stones or mass.Left Kidney: Sagittal length: 44.9 mm. Pelvis: 0.76 mm.The size, architecture, echogenicity and contour are normal for left kidney. There is no evidence of obstructive pattern. No stones or masses are noted. Right Kidney: Sagittal length: 43.0 mm. Pelvis: 0.70mm.The size, architecture, echogenicity and contour are normal for right kidney. There is no evidence of obstructive pattern. No stones or masses are noted.Left Adrenal gland: Height : 4.2 mmThe left adrenal gland is within normal limits for size, echotexture and echogenicity. The capsule is smooth and normal in contour.  Right Adrenal gland: Height : 4.3 mmThe right adrenal gland is within normal limits for size, echotexture and echogenicity. The capsule is smooth and normal in contour.  Spleen: Thickness: 9.6mmThe spleen is within normal limits for size, echogenicity, shape, echotexture and contour. There is no evidence of splenic vessel thrombosis. Porto-systemic blood flow is hepatopetal.  Stomach: wall thickness: 2.6 mmThe stomach contains a small to moderate volume of gas and ingesta, preventing visualization of the gravity dependent portion of the gastric wall and gastric lumen. The gastric wall is within normal limits for layering and thickness. The pyloric-duodenal junction (PDJ) is normal, without visible foreign body, mass lesion or obstructive pattern. Duodenum: wall thickness: 2.6 mmThe duodenum is within normal limits for thickness and layering. No obstructive pattern was identified. Jejunum: wall thickness: 2.5 mmThe Jejunum is within normal limits for thickness and layering.  No obstructive pattern was identified. Ileocolic junction: ileum wall thickness: 2.3 mmWithin normal limits for thickness and layering, gas is present in the cecum.  Colon: wall thickness: 1.1 mmThe colon is within normal limits for thickness and layering.  Pancreas: Left lobe: 4.8 mm. Right lobe: 4.3 mm. The left and right lobe of the pancreas are visualized. The pancreas is within normal limits for echogenicity, echotexture, contour and thickness.  Liver: The liver is within normal limits for size, echogenicity, echotexture and contour.  Biliary system: Gallbladder wall thickness: 0.6 mm. The gallbladder contains a small volume of anechoic bile. The gallbladder wall is normal in thickness. The visualized portions of the extra-hepatic biliary tract are normal. Lymph nodes: All visualized intra-abdominal lymph nodes are normal in size, echotexture and echogenicity Peritoneum/Mesentery/Blood vessels:There is no evidence of intra-abdominal fluid and the mesentery and peritoneum are within normal limits.  The vena cava is adequately filled and compresses with the cardiac cycle.  CONCLUSIONS:Fairly unremarkable ultrasound.   

- o spoke nurse MW/msg - still licking belly, o keen for abdo u/snd - options - abdo u/snd just in case abdo issue , diet trial hypoallergenic in case allergy, specialist derm referral, ensure strict flea control, etc- bloods done Jan - all WNL--------email:Dear Li,I got your phone message from nurse Michelle that unfortunately Eggyolk is still licking his belly skin despite his Redipred medication - was he still licking his belly when on the medication and collar off at same time?The most common cause of licking of the belly/overgrooming tummy is allergy (environment, flea allergy or food - latter is less common but possible) - the possibility of problem inside his tummy is not completely impossible but less common especially since he does not appear to have any abdominal symptoms (although this does not completely rule it out). Behaviour (anxiety) cause may also occur although this is considered less likely. Options for ongoing management for Eggyolk:1) Abdominal ultrasound can be organised to rule out tummy issue (estimate attached) - phone clinic to organise if you would like this done. This gentle procedure may require sedation to help calm Eggyolk as he would be laying on his back and he would also have his belly shaved.2) Dermatology specialist referral to investigate skin causes - allergy testing, food trial, medications to manage. A food trial (strict hypoallergenic diet for 6-8 weeks) can be done prior to referral also as an option. I hope the above information may help with options for a ongoing plan for Eggyolk that may suit you - let us know if any of the above may help you and please call/email if you would like more information before proceeding. Best regards,Dr Jenny

.- licking belly still/recurring, wanting abdo u/snd- eyes not runny anymore so thinks not allergy- eating well, toilet ok- quieter in general since matured but not esp lethargic/etc- eliz collar on when giving pred so not able to tell if stopped licking but o thinks did seem not be trying to lick, off pred now and licking noticed yesterday- discuss possib relapse of allergy, option to try re-introduction of redipred - couple days initially with e-collar then try taking off collar and obs if licks, if does settle then probably suggestive allergy (versus intraabdominal problem)- if recurring/ongoing/etc then option for non-cortisone meds (apoquel, atopica), food trial- if not helping/responding then abdo u/snd to rule out abdo issue, bloods done in Jan all ok