C10022309 / invoice 10000

The expected gap amount to be paid by the client (based on the estimate submitted) is: $29.50

Have reminders been checked? Y/N NoneGapOnly claim Insurance SummaryFirst Clinic Signs:headpressing last night, bit owner (behaviour change)Diagnosis/Suspected: behavioural vs renal vs neurological vs HE vs otherAny other conditions being treated/known health concerns(if any): NoTreatment/Plan: discussion about further diagnostics, owner wishes to do bloodwork but would like a preapproval done up firstPresented for behaviour changes. BIOP 2yrs. Bit owner last week with no inciting cause. Randomly jumped up and latched onto arm. Seemed annoyed all day which is not usually like him. No environmental changes - indoor only. Last night woke up and he was head-pressing against the wall. Has not seen this again. No toxins. EDDU, no vx/dx, no pupd. Used to be an outdoor cat, now indoors, gets grumpy at night-time. Cat in past began headpressing and was very ill. Diet - Fancy + TreatsPrev - No Meds/Hx - NoPE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Dentition 4 - Fx carnassial, suspects needs extractingEyes: Bilaterally symmetrical,  clear and no presence of discharge, menace/PLR/palpabral reflexes intactEars: No erythema or discharge noted Integument: NAD GIT Palpation: Abdomen comfortable on palpation, no obvious masses, kidneys even and non-painfulMSK: Comfortable on flexion and extension. No lameness noted. Proprioception WNL.Assessment      Ddx: Behavioural vs uraemia vs hepatic encephalopathy vs shunt vs neurological vs other Discussed differentials with owner, owner suspects anxiety but is quite anxious about renal disease (has been online researching diseases). Discussed beginning with a blood-test initially. Owner wishes to put through pre-approval prior to this. Would consider bile acids if signs progress / do not improve.