C10028528 / invoice 10000
Species:CANINE
Breed:Maltese Cross
Age (years):13
Diagnosis or signs:check
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div> <p>Subjective:<br>- Chronic med review for Poppy<br>- ongoing cough-hasnt worsened<br>- One bad coughing episode end of January when parents caring for her<br>- Occasional coughing throughout day, reduced from pre-medication levels but not 100% resolved<br>- Sleeping respiratory rate not measured recently, appears calm and quiet at rest<br>- Weight loss from 3.8-3.9kg to 3.5kg with diet change<br>- Gastrointestinal upset with diarrhoea and vomiting on kangaroo SPD wet food<br>- Now stabilised on chicken SPD wet food<br>- Increased appetite, feeding 60-75g twice daily instead of packet-recommended 50g<br><br>Past Medical History:<br>- Mitral valve disease confirmed on echocardiogram end of December<br>- Pulmonary hypertension <br>- Currently on pimobendan and sildenafil liquid medications-GETTING FROM PET CIRCLE<br><br>Objective:<br>- Heart and lungs: WNL<br>- Chest: Clear, no crackles or fluid sounds<br>- Abdomen: Normal<br>- Heart murmur unchanged from previous examination<br>- Weight: 3.5kg (stable from December)<br><br>Assessment:<br>- Mitral valve disease with moderate mitral regurgitation and tricuspid valve thickening with large tricuspid regurgitation jet<br>- Pulmonary arterial hypertension<br>- The coughing could be secondary to bronchial compression due to the enlarged LA and also the moderate pulmonary hypertension-can consider codeine in future if gets worse<br><br>Plan:<br>- Continue pimobendan (vetmedin) at current dose<br>- Continue sildenafil 10mg/ml liquid, increased to 100ml bottle for better supply duration<br>- Monitor sleeping respiratory rate<br>- Repeat echocardiogram in 3-4 months (6 months post-initial study)<br>- Continue chicken SpD wet food, current feeding amounts acceptable given weight stability</p> </div></html>
Animal clinical history (3 most recent)
2026-01-05T00:00:00Z 14:11:00
OWNER CALLED SAID STARTING FEEDING PRIME100 KANGAROO, DAY 3 VOMITED, BILE WITH BLOOD AND D ++ WITH BLOOD AND MUCUS CURRENTLY FEEDING DRY FOOD IN AM / PRIME100 KANGAROO IN PMSTOPPED PRIME OWNER ALSO MENTIONED SOMETHING SIMILAR HAPPENDED A COUPLE YEARS AGO WHEN ADDING IN NEW FOOD GOT THE v+/d+ O WOULD LIKE TO KNOW WHERE WE GO FROM HERE REGARDING DIET ---------------------------------------FROM NG: - Would add in Gut Protect / Gut Restore for 8-12 weeks for gut healing as she shouldn't be soo sensitive - Did they introduce the Prime 100 slowly? Maybe Lyka would be more suitable and SLOW transition ----------------------------------------------------FROM AA, comms with OSpoke to owner and told to pick up some gut protect and gut restore, o mentioned he also brought chicken prime 100 told owner could try the prime100 chicken and very very slowly introduce the food over time espcially if we have such a sensetive tummy, would be good idea to get her on the gut supps to help aid that.Owner will look at picking up the supps.
2025-12-22T00:00:00Z 16:15:00
US with Insights shows MMVD, reccommendation to start vetmedin 0.25mg PO BID + sildenfail 1mg PO BID Monitor Resting respiratory rate Order: Vetmedin liquid Sildenafil liquid PetCircle Pharmacy online
2025-12-19T00:00:00Z 11:01:00
Summary: - Left atrium enlarged - Pulmonary hypertension Should be strated on vetmedin and sildenafil May need CT scan for cough Vetmedin (0.25mg PO BID = 0.875mg BID, best option may be to order liquid from Petcircle) Sildenafil (1-3mg/kg PO TId)
Previous claim history (11)
| Date | Claim # | Diagnosis |
|---|---|---|
| 2025-12-22 | C09662803 | HEART (CARDIAC) VALVE DISORDER |
| 2025-12-22 | C09812686 | HEART (CARDIAC) VALVE DISORDER |
| 2025-12-19 | C09653293 | COUGHING - PRESENTING COMPLAINT |
| 2025-12-16 | C09631514 | COUGHING - PRESENTING COMPLAINT |
| 2021-10-02 | C8784303 | WOUND - LACERATION |
| 2021-07-02 | C8784292 | PRESCRIPTION DIETS |
| 2021-04-23 | C8784292 | TRACHEITIS |
| 2021-04-23 | C8784292 | Preventative/Elective Procedure |
| 2020-12-15 | C8784281 | UROLITHIASIS |
| 2020-11-17 | C8784281 | VACCINATIONS OR HEALTH CHECKS |
| 2020-11-17 | C8784281 | FLEA/TICK/WORM CONTROL |
Line items(lines with upstream diagnosis are skipped by the model)
| Line | tstarc | Amount | Date | Upstream diagnosis |
|---|---|---|---|---|
| 10000 | tstarc_consultation | 110.00 | 2026-03-13 | — |
| 20000 | tstarc_prescription_fee | 70.00 | 2026-03-13 | — |
UPM+
- DG02221HEART (CARDIAC) VALVE DISORDERDSTP_heart_condition_-_valve_disorder
Variant (sleepy_king)
HEART (CARDIAC) VALVE DISORDER
DSTP_heart_condition_-_valve_disorder
Conf: 0.920
Threshold: 0.70
Above: ✓
Correct?