C10024108 / invoice 10000

Reason: Potential SeizuresAppointment Notes: 10.03.2026 - Requested Hx from Ref Vet and The Gap Vetshx's & bloods attachedNotes XWHistory: 9/3/26: Presented to RV for ataxia and nystagmus. Before presentation to RV, he had an episode of ataxia and horizontal nystagmus. His tail was tucked under and was walking towards the left before collapsing and laying sternal. He was conscious, responsive, no urination or defecation, and no pre-ictal or post-ictal signs.This lasted for about a minute. O has a video on this, however does not have a close up on the nystagmus. Was presented to Red Hill vet but by then, he had returned back to normal. Bloods were performed and no abnormalities seen on CBC MBA. O mentioned that there were 3x episodes last year, described as splaying of hips and staggering / falling towards the LHS. These episodes similarly also lasted for  minute. He was conscious responsive with no urination or defecation and no pre-/post-ictal signs. Outside of these episodes, O has no other concerns for him. Owner's primary goal/concerns today - investigation into ictal events Appetite – NormalDiet – RC dental care kibble Water intake – NormalUrination – NormalDefecation – NormalVomiting/diarrhoea – NoneCoughing/sneezing – NoneEnergy levels – NormalExercise/activity – Goes for active walks Weight changes – NoneBehavioural changes – NonePreventative medications – Did not discuss Indoor/outdoor access - BothToxin exposure – None notedBIOP – Since puppy Other pets at home - Did not discuss Previous medical history –  Severe separation anxiety from Os. Current medications: Fluoxetine 10mg PO SID (O reports has not been helpful in managing his anxiety)Examination findings: T:  NT                 MM: pink and moistP:  140bpm        CRT: 1-2 secR:  24Demeanour: BARHydration: EuhydratedWeight: 8.3kg BCS: 5/9MCS: 3/3Cardiovascular: No murmur auscultated, sinus rhythm, femoral pulses strong and synchronous Respiratory: Clear bronchovesicular sounds bilaterally, normal respiratory effort.Abdomen: Soft, comfortable on palpation. No mass effect appreciableOral exam: No obvious oral lesionsEars: No erythema or discharge notedEyes: No lesions or discomfort notedIntegument: No lesions noted. Lymph nodes: Symmetrical, NSF Gait: NormalMusculoskeletal: Full exam np, no obvious lameness.  Rectal: NP Neurologic exam findings: Mentation/Demeanour - BARGait and posture – No significant findingsProprioception – PPR, RS and hopping intact in all limbs, intact handstandMotor function:1.Spinal reflexes - Patellar, proximal sciatic, CTR, perineal reflex intact and normal 2.Muscle bulk - Normal3.Muscle tone - NormalCranial nerves - Palpebral, menace, PLR intact and normal. NO strabismus or nystagmus (positional or when lying upside down). Normal VOR. Continence - IntactVertebral hyperpathia – None noted Nociception - IntactOphthalmic exam - NPAdditional findings - L bullae discomfort mildNeuroanatomical localisation:Open.- possible vestibularProblem list:Ictal events - ataxia and horizontal nystagmusPotential causes:1.  Transient vestibular events - intermittent changes in endolymph flow/pressure, transient vascular related events, vestibular seizures (temporal lobe epilepsy)2. Movement disorders - Paroxysmal dyskinesia 3. Infectious/inflammatory: Otitis interna/media, PSOM, MUO, neoplasiaAssessment:Basil's neurological examination today reveals that he has a history of ictal events - characterised by ataxia and horizontal nystagmus.the neuroanatomical localisation of these clinical signs is open at this stage. But given the presence of nystagmus, it seems likely that the vestibular system is involved. The primary differential diagnosis at this stage is transient vestibular eventsOther differential diagnoses to consider include movement disorders such as Paroxysmal dyskinesia due to ictal events with presence of consciousness, lack of autonomic nervous signs (urination, defecation), and lack of pre-post ictal signs. However, the nystagmus would be unusual. Other causes of vestibular signs could be infectious/inflammatory - otitis interna/media, PSOM and MUOIt is recommended at this stage to either consider an MRI +- spinal tap, or for owner to monitor. Plan:To consider an MRI. And if O wishes to do so, to call reception to have this organisedA referral to a behaviourist due to anxiety may be helpful.    Vital Signs    Weight: 8.3;