Presenting complaint: Increased litter box visits with visible straining to urinate. One blood spot observed inside the litter box immediately after Barkoba urinated. Owner had been monitoring via Neakasa smart litter box app and noticed 17 litter box visits in a single day β suspicious of the high frequency, owner followed Barkoba to the litter box and directly witnessed the blood spot. Brought to Nuro Vet the same day.
Attending vet: Nurovet Clinic, Cyberjaya (doctor name not recorded)
Weight: 6.36 kg (confirmed β Nurovet lab report header)
Diagnosis: FIC β Feline Idiopathic Cystitis. Crystals negative. Condition assessed as more consistent with cystitis. Possible contributing factors per attending vet: obesity, insufficient water intake, and habit of retaining urine.
Sample: Urine Β· Colour: Yellow Β· Clarity: Clear and Transparent Β· Dilution ratio: 1
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| 1. Cast | |||
| Hyaline cast (HYA#) | 0.33/uL (0.31/LPF) | 0β0.8/uL | Normal |
| Cellular cast (CEC#) | 0.00/uL | 0/uL | Negative |
| Granular cast (GRA#) | 0.00/uL | 0/uL | Negative |
| Waxy cast (WAC#) | 0.00/uL | 0/uL | Negative |
| 2. Crystal β ALL NEGATIVE | |||
| Struvite (MAP#) | 0.00/uL | 0β5/uL | Negative |
| Calcium oxalate monohydrate (COMC#) | 0.00/uL | 0/uL | Negative |
| Calcium oxalate dihydrate (COD#) | 0.00/uL | 0β3/uL | Negative |
| Calcium phosphate (CP#) | 0.00/uL | 0/uL | Negative |
| Uric acid (UAC#) | 0.00/uL | 0/uL | Negative |
| Cystine (CYSC#) | 0.00/uL | 0/uL | Negative |
| 3. Cells | |||
| RBC# | 9.33/uL (0.18/HPF) | 0β25/uL | Normal |
| WBC# | 7.21/uL (0.14/HPF) | 0β25/uL | Normal |
| Renal Tubular Epithelial cell (RTE#) | 10.60/uL (0.21/HPF) | 0/uL | β POSITIVE |
| Squamous Epithelial cell (SEC#) | 8.06/uL (0.16/HPF) | 0β7/uL | β POSITIVE |
| Transitional Epithelial cell (TEC#) | 1.27/uL (0.03/HPF) | 0β3/uL | Normal |
| Sperm (SPE#) | 0.00/uL | 0/uL | Negative |
| 4. Germ β ALL NEGATIVE | |||
| Cocci (COS#) | 0.00/uL | 0/uL | Negative |
| Rods (BAC#) | 0.00/uL | 0/uL | Negative |
| Yeast (SAC#) | 0.00/uL | 0/uL | Negative |
| 5. Others | |||
| Lipid drop (FAT#) | 31.67/uL (2.49/HPF) | 0β160/uL | Normal |
| Mucus (PHL#) | 0.00/uL | 0β3/uL | Normal |
| Machine-Flagged (Unclassified) | |||
| Suspected cast (SCAS#) | QTY 15/960 photos | β | Flagged by analyser β not classified |
| Suspected crystal (SCAS#) | QTY 2/960 photos | β | Flagged by analyser β crystals overall NEGATIVE per Dr Nurin |
Lab diagnostic notes (Awalife system): [RTE#>0] common in renal tubular disease, ischaemia, nephrotoxicity and degenerative kidney disease. [SEC#>7] common in urinary system inflammation and bladder puncture sampling.
Vet interpretation and instructions (WhatsApp, Nurovet): Results point more to a urinary issue than a kidney problem. RTE elevation is consistent with normal tissue sloughing during an active UTI β not necessarily indicative of renal disease. Condition is more consistent with cystitis (FIC). Owner advised to ensure Barkoba drinks plenty of water and to minimise stress. Medications to be completed within one week. Blood test recommended to confirm kidney parameters (urea, creatinine) if required. No need to repeat urinalysis unless haematuria returns.
Medications dispensed (confirmed: Invoice INV-6646):
Note: Medications dispensed and administered by clinic on 27 April 2025. Home course commenced 28 April 2025. Course to be completed within one week.
Bill: RM 202.50 (Consultation RM 20.00 Β· Urinalysis RM 70.00 Β· Medications RM 112.50)
Urinary supplements started: Pet Wellbeing + Vetriscience. RM 274.25.
Attending vet: Dr Aishah β Petsville Animal Clinic, Cyberjaya
Weight: 6.42 kg Β· Temperature: 38.5Β°C (Normal) (confirmed β WhatsApp, Dr Aishah)
Diagnosis: Suspected urinary tract disease with nephrolithiasis (kidney stone identified on ultrasound). SDMA markedly elevated β Kidney Disease Probable. Haemoconcentration noted on CBC (elevated RBC, HGB, HCT). Stone type not identified β Petsville does not have the equipment for stone typing; per Dr Aishah, urine sample can be sent to an external laboratory (results in approximately 2 weeks), however treatment plan would remain unchanged regardless of stone type.
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| WBC | 5.7 Γ10Β³/mmΒ³ | 5.0β11.0 | Normal |
| LYM% | 36.7% | β | β |
| MON% | 2.2% | β | β |
| GRA% | 61.1% | β | β |
| EOS% | 4.5% | β | β |
| LYM# | 2.10 Γ10Β³/mmΒ³ | 1.00β4.00 | Normal |
| MON# | 0.10 Γ10Β³/mmΒ³ | 0.00β0.50 | Normal |
| GRA# | 3.50 Γ10Β³/mmΒ³ | 3.00β12.00 | Normal |
| EOS# | 0.25 Γ10Β³/mmΒ³ | 0.00β0.60 | Normal |
| RBC | 11.27 Γ10βΆ/mmΒ³ H | 5.00β10.00 | β HIGH β haemoconcentration |
| HGB | 18.8 g/dL H | 8.0β17.0 | β HIGH |
| HCT | 57.3% H | 27.0β47.0 | β HIGH |
| MCV | 51 Β΅mΒ³ | 40β55 | Normal |
| MCH | 16.7 pg | 13.0β17.0 | Normal |
| MCHC | 32.8 g/dL | 31.0β36.0 | Normal |
| RDW | 16.3% L | 17.0β22.0 | β LOW |
| PLT | 221 Γ10Β³/mmΒ³ | 180β430 | Normal |
| MPV | 8.3 Β΅mΒ³ | 6.5β15.0 | Normal |
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| GLU | 125 mg/dL | 74β152 | Normal |
| BUN | 30.2 mg/dL | 15.0β37.0 | Normal |
| CREA | 1.6 mg/dL | 0.7β2.1 | Normal |
| B/C ratio | 19 | β | β |
| PHOS | 3.7 mg/dL | 2.6β6.4 | Normal |
| CA | 11.1 mg/dL | 8.9β12.6 | Normal |
| TP | 8.3 g/dL | 5.8β9.1 | Normal |
| ALB | 3.6 g/dL | 2.2β4.1 | Normal |
| GLOB | 4.7 g/dL | 3.0β5.7 | Normal |
| A/G | 0.8 | β | β |
| ALT | 64 U/L | 13β109 | Normal |
| ALP | 62 U/L | 9β109 | Normal |
| GGT | 0 U/L | 0β5 | Normal |
| TBIL | 0.15 mg/dL | 0.00β1.00 | Normal |
| CHOL | 208 mg/dL | 50β230 | Normal |
| LIPA | <20 U/L | 0β32 | Normal |
| AMY | 1433 U/L | 500β1400 | β Mildly elevated |
HEM: 0 Β· LIP: 0 Β· ICT: 0 (no interference). Vet annotation on printout circled: BUN, CREA, ALT, ALP, AMY β noted "CKD" with handwritten annotation "9.14" (interpretation unclear).
SDMA β Vcheck (SN: VE20FBITG4733, 06/06/2025 12:36, Operator: PETSVILLE):
Ultrasonography β bladder (30 minutes): Kidney stone identified on ultrasound. Stone type not determinable at Petsville (no specialist equipment). Per Dr Aishah: treatment plan remains unchanged regardless of stone type β Royal Canin Urinary S/O diet, supportive medications, and follow-up ultrasound and blood test.
Lab diagnostic notes: Elevated RBC, HGB and HCT consistent with haemoconcentration (dehydration). SDMA markedly elevated above 100 Β΅g/dL β Kidney Disease Probable, to be interpreted alongside creatinine (1.6 mg/dL β within reference range) and other clinical findings. Amylase mildly elevated (1433 U/L). All other parameters within reference ranges. Analyser alarms: MIC, AG1 flagged on CBC.
Alarming signs β owner monitoring instructions (WhatsApp, Dr Aishah): Seek immediate veterinary attention if any of the following occur: (1) no urination within 24 hours, (2) fresh blood in urine, (3) non-stop vomiting. These are signs of urinary obstruction, which is common in male cats with a history of FLUTD.
Medications dispensed (confirmed: Invoice INV-064574 + medication labels):
Note: Per Dr Aishah β medications and Royal Canin Urinary S/O are intended to increase urinary frequency and water intake to facilitate passage of the stone.
Bill: RM 753.00 (Consultation RM 20 Β· SDMA RM 150 Β· CBC + Biochemistry RM 220 Β· Ultrasonography RM 70 Β· Medications RM 135 Β· Royal Canin S/O RM 158)
Attending vet: Dr Aishah binti Dharmahdi β Petsville Animal Clinic, Cyberjaya
Diagnosis: Persistent urinary tract infection with crystalluria (calcium phosphate crystals confirmed on microscopy). Kidney stone measurements obtained on ultrasound. Crystals identified as insoluble β cannot be dissolved through diet alone. Urine highly concentrated. pH acidic at 6 β vet note: "too alkaline" environment promotes crystal formation; pH control and dietary mineral reduction recommended.
| Parameter | Result | Reference | Flag / Vet Note |
|---|---|---|---|
| Occult Blood | Negative (0) | Negative | Normal |
| Bilirubin | Negative (0) | Negative | Normal |
| Urobilinogen | 4 (approx. 4 mg/dL) | Normal | Mildly elevated Β· Vet note: "tinggi sikit / slight high, bacteria" |
| Ketone | Negative (0) | Negative | Normal |
| Protein | Negative (0) | Negative | Normal |
| Nitrite | POSITIVE | Negative | β Suggestive of bacterial infection (UTI) |
| Glucose | Negative (0) | Negative | Normal |
| pH | 6 | 6.0β7.5 | Slightly acidic Β· Vet note: "might acidic, ada campur dgn struvite oxalate" |
| Specific Gravity | 1.060 | 1.035β1.060 | Highly concentrated urine Β· At upper limit of normal |
| Leukocytes | Trace (25) | Negative | Trace β may indicate inflammation or mild infection Β· Vet note: "infection @ kidney" |
| Ascorbic Acid | 40 mg/dL | β | High β may interfere with other readings |
| Finding | Result | Vet Note |
|---|---|---|
| Calcium phosphate crystals | PRESENT | Confirmed on microscopy β needle-shaped crystals visible on slide image. Vet circled as primary finding. |
| Crystal type differential (vet handwritten note) | Insoluble β "mcm calcium oxalate" (resembles calcium oxalate morphology) | Vet noted "Γ struvite, Γ oxalate" as differentials ruled out β calcium phosphate identified as the insoluble crystal present. "Tak Boleh larut" β cannot be dissolved. |
Vet management note: Control pH. Electrolyte too alkaline (pH 6). Diet β reduce mineral content.
| View | D1 Measurement | D2 Measurement |
|---|---|---|
| View 1 (kidney/renal pelvis area) | 0.99 mm | 0.87 mm |
| View 2 (echogenic focus β stone) | 1.6 mm | 2.5 mm |
Ultrasound settings: B mode, Gen-L probe, 32 Hz, G 49%, depth 60β69mm. Echogenic foci consistent with nephrolithiasis/urolithiasis.
Lab diagnostic notes: Nitrite positive indicating active bacterial involvement. Leukocytes trace β mild inflammation or infection at kidney level per vet annotation. Calcium phosphate crystals present on microscopy β insoluble type, cannot be eliminated through diet modification alone. Urine SG 1.060 indicates highly concentrated urine, increasing crystallisation risk. High ascorbic acid (40 mg/dL) may have interfered with some dipstick readings. pH 6 β vet noted that mixed crystal environment (struvite/oxalate) can occur at this pH.
Medications dispensed (confirmed: Invoice INV-064971):
Bill: RM 402.00 Β· Paid: RM 302.00 (Maybank QR, 18 Jun 2025, 4:56 PM) Β· Balance outstanding: RM 100.00
(Consultation RM 20 Β· Calmurofel RM 35 Β· Azodyl RM 50 Β· Clavaseptin RM 48 Β· Bactigen Eye Drops RM 15 Β· RC Renal 2kg RM 110 Β· RC Urinary SO Pouch RM 12 Β· RC Renal Pouch RM 12 Β· Ultrasonography RM 70 Β· Urine Dipstick RM 30)
Attending vet: Dr Muhammad Khayeer Al-Farouq β Jawharicat Veterinary Centre, Ampang
Reason for visit: Owner brought Barkoba to Jawharicat specifically for a complete blood panel, as previous facilities did not have the full test capability.
Weight: 6.83 kg (confirmed β IDEXX report header and WhatsApp Dr Farouq: "beratnya steady 6.83 kg")
Diagnosis: Cardiac muscle injury highly suspected based on markedly elevated Troponin I (fTnI 0.65 ng/mL β Abnormal). NT-proBNP normal β no cardiac swelling detected. Kidney parameters reassuringly normal: SDMA normal, creatinine normal, UPC normal β Dr Farouq noted kidney has likely started to stabilise or compensate in the presence of the stone. Urine culture sent to Innoquest β result pending at time of visit.
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| RBC | 9.55 Γ10ΒΉΒ²/L | 6.54β12.20 | Normal |
| HCT | 43.4% | 30.3β52.3 | Normal |
| HGB | 14.5 g/dL | 9.8β16.2 | Normal |
| MCV | 45.4 fL | 35.9β53.1 | Normal |
| MCH | 15.2 pg | 11.8β17.3 | Normal |
| MCHC | 33.4 g/dL | 28.1β35.8 | Normal |
| RDW | 23.3% | 15.0β27.0 | Normal |
| %RETIC | 0.1% | β | β |
| RETIC | 6.7 K/Β΅L | 3.0β50.0 | Normal |
| RETIC-HGB | 15.8 pg | 13.2β20.8 | Normal |
| WBC | 9.28 Γ10βΉ/L | 2.87β17.02 | Normal |
| %NEU | 68.1% | β | β |
| %LYM | 25.0% | β | β |
| %MONO | 2.2% | β | β |
| %EOS | 4.1% | β | β |
| %BASO | 0.6% | β | β |
| NEU | 6.32 Γ10βΉ/L | 2.30β10.29 | Normal |
| LYM | 2.32 Γ10βΉ/L | 0.92β6.88 | Normal |
| MONO | 0.20 Γ10βΉ/L | 0.05β0.67 | Normal |
| EOS | 0.38 Γ10βΉ/L | 0.17β1.57 | Normal |
| BASO | 0.06 Γ10βΉ/L | 0.01β0.26 | Normal |
| PLT | 239 K/Β΅L | 151β600 | Normal |
| MPV | 16.1 fL | 11.4β21.6 | Normal |
| PCT | 0.38% | 0.17β0.86 | Normal |
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| GLU | 12.94 mmol/L | 4.11β8.84 | β HIGH β stress hyperglycaemia suspected |
| SDMA | 12 Β΅g/dL | 0β14 | Normal |
| CREA | 174 Β΅mol/L | 71β212 | Normal |
| UREA | 8.9 mmol/L | 5.7β12.9 | Normal |
| BUN/CREA | 13 | β | β |
| PHOS | 0.55 mmol/L | 1.00β2.42 | β LOW |
| CA | 2.69 mmol/L | 1.95β2.83 | Normal |
| TP | 88 g/L | 57β89 | Normal |
| ALB | 30 g/L | 22β40 | Normal |
| GLOB | 57 g/L | 28β51 | β HIGH β elevated globulin, chronic inflammation/infection |
| ALB/GLOB | 0.5 | β | β |
| ALT | 85 U/L | 12β130 | Normal |
| ALKP | 58 U/L | 14β111 | Normal |
| GGT | 4 U/L | 0β4 | Normal |
| TBIL | 7 Β΅mol/L | 0β15 | Normal |
| CHOL | 5.77 mmol/L | 1.68β5.81 | Normal |
| AMYL | 1104 U/L | 500β1500 | Normal |
| LIPA | 351 U/L | 100β1400 | Normal |
| Na | 163 mmol/L | 150β165 | Normal |
| K | 3.8 mmol/L | 3.5β5.8 | Normal (lower end) |
| Na/K | 43 | β | β |
| Cl | 122 mmol/L | 112β129 | Normal |
| UPRO | 0.14 g/L | β | β |
| UCRE | 2.25 g/L | β | β |
| UPC | 0.06 | <0.4 cats | Normal β no significant proteinuria |
| Osm Calc | 333 mmol/kg | β | β |
IDEXX interpretation note: SDMA and CREA within reference interval β impairment of GFR is unlikely. Recommended next step: evaluate complete urinalysis.
| Test | Result | Reference | Interpretation |
|---|---|---|---|
| NT-proBNP (VCheck, 11:55) | Below 50.00 pmol/L | <100 pmol/L = Normal | NORMAL β no cardiac swelling detected |
| fTnI / Troponin I (VCheck, ~12:xx) | 0.65 ng/mL | <0.18 = Normal Β· 0.18β0.28 = Equivocal Β· >0.28 = Abnormal | ABNORMAL β cardiac muscle injury suspected |
Urine Specific Gravity (IDEXX): USG 1.034 (confirmed β WhatsApp Dr Farouq) Β· Note: Innoquest urine culture report recorded SG 1.020 (collected 26 Jun 11:30) β slight discrepancy likely due to different measurement timing or method.
| Section | Parameter | Result | Reference | Flag |
|---|---|---|---|---|
| Urine Appearance | Transparency | Slightly Turbid | β | β |
| Colour | Yellow | β | β | |
| Chemistry | SG | 1.020 | β | β |
| pH | 8.0 | β | Alkaline | |
| Leucocytes | Β± (trace) | Nil | Trace present | |
| Blood | +++++ | Nil | ββ STRONGLY POSITIVE | |
| Nitrite | Negative | Negative | Normal | |
| Ketones | Nil | Nil | Normal | |
| Bilirubin | Nil | Nil | Normal | |
| Urobilinogen | Nil | Nil | Normal | |
| Protein | Nil | Nil | Normal | |
| Glucose | Nil | Nil | Normal | |
| Microscopy | Leucocytes | 15 Γ10βΆ/L | <10 Γ10βΆ/L | β Elevated |
| Erythrocytes | >250 Γ10βΆ/L | <3 Γ10βΆ/L | βββ MARKEDLY ELEVATED β significant haematuria | |
| Epithelial Cells | Nil | Nil | Normal | |
| Casts / Crystals | No casts or crystals seen | β | Normal | |
| CULTURE | NO GROWTH | β | β No bacterial growth | |
Lab diagnostic notes: All CBC parameters within normal range β no anaemia, no significant leukocytosis, PLT normal. Kidney panel reassuringly normal: SDMA 12 Β΅g/dL (ref 0β14), creatinine 174 Β΅mol/L (ref 71β212), UPC 0.06 β no significant proteinuria. Per Dr Farouq, kidney has likely started to stabilise or compensate with the stone present. Globulin elevated (57 g/L) β consistent with chronic inflammation or infection. Glucose elevated (12.94 mmol/L) β likely stress hyperglycaemia. Phosphorus low (0.55 mmol/L). Troponin I critically elevated at 0.65 ng/mL β cardiac muscle injury highly suspected. NT-proBNP normal β no cardiac swelling. Urine culture: No growth (Innoquest Lab No. 25-1801854, collected 26 Jun 11:30, reported 28 Jun 12:10). Markedly elevated erythrocytes in urine (>250 Γ10βΆ/L) confirm significant haematuria despite no visible blood reported β consistent with active urinary tract pathology.
Dr Farouq interpretation (WhatsApp): NT-proBNP is a test to check whether the heart is swelling β for Barkoba, NT-proBNP is normal (Alhamdulillah). Troponin I (fTnI) tests whether the heart muscle itself is injured β Barkoba's troponin reading is high and abnormal. This highly suggests cardiac muscle injury. Blood test otherwise not that bad β kidney parameters have stabilised. Barkoba looks clinically solid. Weight steady at 6.83 kg.
Medications dispensed: None β this was a diagnostic-only visit. No medications prescribed on this date.
Bill: RM 1,135.00 (Consultation RM 50 Β· IDEXX CBC ProCyte RM 115 Β· IDEXX Chem 17 RM 195 Β· IDEXX Chem Lyte RM 75 Β· IDEXX SDMA RM 120 Β· VCheck NT-proBNP RM 200 Β· VCheck Troponin I RM 180 Β· IDEXX UPC RM 150 Β· Urine SG RM 50)
Attending vet: Dr Aishah binti Dharmahdi β Petsville Animal Clinic, Cyberjaya
Presenting complaint: At 9:24 AM on 28 June 2025, owner contacted Petsville via WhatsApp to report that Barkoba was attempting to use all litter boxes but producing no urine. This was the first time Barkoba had been observed vocalising β owner suspected urinary obstruction. Owner brought Barkoba to the clinic at 10:19 AM same day. At 3:46 PM, Dr Aishah reported that Barkoba's bladder was the size of a ping-pong ball and turgid. Clinic proceeded with urinary catheterisation.
Diagnosis: Urinary obstruction with markedly distended bladder. Stress hyperglycaemia on pre-catheterisation bloods. Catheter placed successfully. Barkoba warded for monitoring and treatment from 28 June to 3 July 2025.
Catheterised urine appearance (30 June 2025 β urine flush photo): Dark golden/brownish heavily discoloured urine in stainless steel bowl β consistent with haematuria, concentrated urine, and sediment. This photo is from the catheter flush on 30 June 2025, Day 3 of ward stay. (Confirmed β photo forwarded via WhatsApp, 30 Jun 2025)
Clinical findings β Dr Aishah (WhatsApp, 28 Jun 2025, ~5:43β5:47 PM):
| Finding | Detail | Source |
|---|---|---|
| Ultrasound β bladder | 30% sediments in bladder. Bladder wall normal size and not swollen. | WhatsApp, Dr Aishah β |
| Ultrasound β urethra | Urethra swollen β causing difficulty urinating. | WhatsApp, Dr Aishah, 28 Jun 5:43 PM β ("saluran kencing bengkak, ini yang menyebabkan Barkoba sakit/susah meneran kencing") |
| Ultrasound β kidney | Kidney stone still present, same size as previously noted. | WhatsApp, Dr Aishah β |
| Blood test β kidney | BUN and CREA within normal range. No other significant findings. | WhatsApp, Dr Aishah β (confirmed by Element DC printout) |
| Catheterisation β flushing | Catheter stuck midway during flushing β due to swollen urethra. No sediments expelled. Slight bleeding only at start of flushing. | WhatsApp, Dr Aishah β |
| Treatment plan | IV drip placed for hydration and to flush out bladder sediments. Urinary catheter to remain for 3 days. On day 4 catheter removed and Barkoba monitored to confirm satisfactory urine output. | WhatsApp, Dr Aishah β |
| Parameter | Result | Reference | Unit | Flag |
|---|---|---|---|---|
| GLU | 238 | 74β152 | mg/dL | ββ HIGH β stress hyperglycaemia in context of obstruction and catheterisation |
| BUN | 17.0 | 15.0β37.0 | mg/dL | Normal |
| CREA | 1.2 | 0.7β2.1 | mg/dL | Normal (improved from 1.6 on 6 Jun) |
| B/C | 14 | β | β | β |
| TP | 7.7 | 5.8β9.1 | g/dL | Normal |
| ALB | 3.1 | 2.2β4.1 | g/dL | Normal |
| GLOB | 4.6 | 3.0β5.7 | g/dL | Normal |
| A/G | 0.7 | β | β | β |
| ALT | 69 | 13β109 | U/L | Normal |
| ALP | 60 | 9β109 | U/L | Normal |
HEM: 0 Β· LIP: 0 Β· ICT: 0. Operator ID: admin. Printed: 28/Jun/2025. Petsville Animal Clinic, Jln Vita 1, Plaza Crystalville, Cyber 12, Cyberjaya. Analyser: Element DC.
Lab diagnostic notes: Glucose markedly elevated (238 mg/dL, ref 74β152) β consistent with stress hyperglycaemia in context of acute urinary obstruction and catheterisation procedure. No diabetes diagnosis. Kidney parameters normal and improved from 6 June (CREA 1.2 vs 1.6). All other parameters within reference range. HEM/LIP/ICT all 0 β no sample interference.
Ward stay β clinical progress (source: owner summary document + referral letter):
| Date | Clinical Notes |
|---|---|
| 28 Jun (Day 1) | Bladder ping-pong ball size, turgid. Catheter placed 3:46 PM under light anaesthesia. Dark heavily discoloured urine collected. IV drip placed for hydration and to flush bladder sediments. (Source: WhatsApp Dr Aishah 28 Jun β) |
| 29 Jun (Day 2) | Barkoba grumpy β knocked food out of cage. IV drip bitten and dislodged β replaced. Flushing completed: urine now clear yellowish, no blood. Owner queried sediment lab identification β clinic to attempt urine spin to collect sediment for processing. (Source: WhatsApp PetsvilleVet 29 Jun 12:46 PM β) |
| 30 Jun (Day 3) | Urine clearing since 29 June. Petsville processed urine sample under microscope β sediment negative. Vet note: continuous flushing likely reduced sediment below detectable level. Microscopy image clear field confirmed. Urine flush photo: dark golden/brownish still visible macroscopically. Urine also spun to collect sediment for particle identification β dark brown/reddish concentrated sediment visible in spun sample. (Source: WhatsApp PetsvilleVet 30 Jun 3:30 PM β Β· Microscopy image β Β· Urine flush + spun sediment photos β) |
| 1 Jul (Day 4) | Blood noticed in urine during flushing β new development after 3 days of clear urine. Vet confirmed: bleeding occurred during flushing with catheter still in place. Attributed to catheter irritation/trauma to urethra and bladder lining after several days β expected complication, not worsening. No signs of serious complications. Catheter removed today. Urethra still inflamed. Monitoring one more night without catheter. Discharge planned for 2 July if Barkoba able to urinate independently with good volume. Owner advised: urine stream may be weak post-discharge as urethral inflammation takes time to resolve β monitor for urinating, eating, acting normally; watch for vomiting or lethargy as signs of toxicity. Infection risk of catheter explained β antibiotics administered throughout ward stay for this reason; maximum catheter duration 4 days. (Source: WhatsApp PetsvilleVet 1 Jul 4:04β5:07 PM β) |
| 2 Jul (Day 5) |
9:30 AM: Diazepam (muscle relaxant) and antipyretic injection administered. Fever: Mild fever present β common after catheter removal, attributed to pain and inflammation. Antipyretic injection given (combined with mild pain reliever). Urine stream: Not smooth β dribbling. Bladder at 1:19 PM a bit softer but still ping-pong ball size. Vet advised against pressing bladder forcefully β risk of bladder rupture if pressed too frequently or forcefully. Awaiting muscle relaxant effect; monitoring bladder size on palpation. Appetite & stool: Good appetite, solid stools β satisfactory digestion and energy. Owner visit: 3:00 PM visitation. Overall assessment: Improving but not ready for discharge. Urinary system needs more healing time. Continuing current medications; will reassess once urination smooth and fever fully settled. Urine culture no growth β Petsville comment (2 Jul 4:59 PM): Owner shared the 26 June Innoquest urine culture result (Lab No. 25-1801854 β No growth) with Petsville. Petsville noted: despite no growth, leucocytes and erythrocytes in urine were markedly elevated β indicating urinary tract inflammation or infection. Barkoba had already received 14 days of antibiotics prior to the culture being taken β bacteria likely eliminated before culture, producing a false negative. Absence of bacteria on culture date does not exclude prior infection. (Source: WhatsApp PetsvilleVet 2 Jul 12:13 PM β 4:59 PM β) |
| 1β2 Jul (post-catheter) | Bladder turgid again. Barkoba feverish. Urine dribbling. Tolfenamic Acid injection administered (antipyretic + anti-inflammatory). |
| 2 Jul | Bladder small and soft on palpation. One puddle of urine in litter box. Fever resolved. General condition improved. |
| 3 Jul (Discharge day) |
Good news update (PetsvilleVet, 10:54 AM): 1. Bladder no longer turgid β soft and smaller than previous day. Urine flow improving. Very good progress. 2. One urine puddle spotted near litter box β positive sign. 3. Appetite and drinking normal β comfortable and improving. 4. Good signs of recovery β discharged today. Complete all medications at home. Home monitoring instructions (PetsvilleVet, 10:57 AM): 1. Frequent litter box visits expected in coming days β only 2 days post-catheter, urethra likely still swollen. 2. Urethral swelling causes sensation of needing to urinate frequently even with little output β normal during recovery phase. 3. Key positive signs: still eating, active, not visibly stressed. As long as urinating, eating and acting normally. 2nd catheterisation decision (10:59 AM): Based on clinical signs today, vet assessed good recovery signs β 2nd catheterisation likely not needed. Better for Barkoba to continue monitoring at home where he is more comfortable. Owner request (9:42 AM): Requested signed referral letter covering 6 June β 3 July, including condition summary, catheterisation details, lab/imaging results, and clinical opinion on next steps. Owner also raised option of proceeding referral before or alongside 2nd catheterisation if needed. Discharge time: 12:00 PM. Referral letter to UPM issued. Post-discharge observations (owner, 3 Jul afternoon): Upon arriving home, Barkoba was wobbly and having difficulty drinking. He then drank water continuously and excessively β appearing extremely thirsty (polydipsia). Owner assessed this as abnormal behaviour, not consistent with normal post-discharge recovery. At 2:37 PM, Barkoba vomited. Owner notified Petsville β clinic advised to monitor first. (Source: WhatsApp PetsvilleVet 3 Jul 9:42 AM β 10:59 AM β Β· Post-discharge owner observation β) |
Medications dispensed (confirmed: Invoice INV-065465 + Petsville referral letter):
Discharge: 3 July 2025, 12:00 PM. Stable condition. Calmurofel extended. Oral prednisolone tapered and continued at home. Referral letter issued to UPM Veterinary Hospital for specialist evaluation. (Sources: referral letter confirmed Β· discharge time confirmed by owner)
Bill: RM 674.00 (Invoice INV-065465) Β· Ward duration: 28 June β 3 July 2025 (5 nights)
Sequence: Discharged Petsville afternoon 3 July β Barkoba drowsy since discharge β rushed to St Angel emergency at approximately 8:30 PM, 3 July 2025.
Physical examination on admission (3 Jul 2025): QAR (Quiet, Alert, Responsive). Pink mucous membranes. Skin tent present. CRT <2s. Clear lung sounds. Subnormal temperature. Bladder: very turgid, moderate to large size, non-compressible β complete urinary obstruction confirmed.
Catheterisation: Closed system urinary catheter placed that midnight (3 July 2025) due to complete blockage. Catheter maintained throughout ICU admission.
Diagnostics on admission β Blood (3 Jul 11:19 PM β IDEXX ProCyte Dx + Catalyst One):
| Parameter | 3 Jul 11:19 PM | 6 Jul 11:33 AM | Reference | Flag |
|---|---|---|---|---|
| RBC (M/Β΅L) | 7.01 | 6.41 | 6.54β12.20 | β LOW by 6 Jul β anaemia developing |
| HCT (%) | 29.0 | 30.0 | 30.3β52.3 | β BELOW NORMAL β non-regenerative |
| HGB (g/dL) | 10.9 | 9.6 | 9.8β16.2 | β Declining |
| RETIC (%) | 0.1 | 0.1 | β | Non-regenerative β bone marrow not responding |
| WBC (K/Β΅L) | 8.87 | 11.92 | β | Rising β infection/inflammation |
| NEU (%) | 65.5 | 53.0 | β | Immature/toxic neutrophils suspected (IDEXX flag) |
| LYM (K/Β΅L) | 5.81 | 4.74 | 0.92β6.88 | High-normal |
| PLT (K/Β΅L) | 180 | 44 | 151β600 | ββ CRITICALLY LOW by 6 Jul β thrombocytopenia |
| MPV (fL) | 16.2 | 21.7 | 11.4β21.6 | β HIGH β platelet activation/consumption |
| GLU (mg/dL) | 14.0 β 158 | 158 | 74β159 | Normal range (stress hyperglycaemia resolving) |
| CREA (mg/dL) | 1.5 | 1.5 | 0.8β2.4 | Normal |
| BUN (mg/dL) | 18 | 18 | 16β36 | Normal |
| TP (g/dL) | 6.6 | 6.6 | 5.7β8.9 | Normal |
| ALB (g/dL) | 2.3 | 2.3 | 2.2β4.0 | β Low-normal β early hypoalbuminaemia |
| ALT (U/L) | 88 | 88 | 12β130 | Normal |
IDEXX flags: (1) Anaemia without reticulocytosis β likely non-regenerative; consider pre-regenerative. (2) Immature and/or toxic neutrophils likely present β consider inflammation. CREA note: test results multiplied by dilution factor (1:4 dilution applied).
Urinalysis on admission (3 Jul 11:52 PM, free catch): Colour: Amber. Clarity: Very Cloudy. SG: 1.020.
Urinalysis 6 Jul (IDEXX UA Analyzer): PRO 500 mg/dL (ββ significant proteinuria), GLU 300 mg/dL (ββ glucosuria β consider stress vs renal tubular disease), BLD 250 Ery/Β΅L (ββ significant haematuria), BIL 1 mg/dL, UBG Negative. IDEXX interpretation: Significant haematuria with proteinuria β consider inflammation, infection, urinary calculi, neoplasia, haemorrhage. Glucosuria with hyperglycaemia β consider stress hyperglycaemia; if normoglycaemic, consider renal tubular disease. SG 1.020 β potentially inappropriate concentration (consider renal disease).
Additional diagnostics during admission:
| Test | Date | Result |
|---|---|---|
| Abdominal plain radiograph | 3 Jul | Performed on admission (findings in full report) |
| Abdominal ultrasound | 3 Jul | Performed on admission |
| Urine culture (Pathlab) | 3 Jul | Sent β results pending within 2 weeks |
| FIV / FeLV / Feline Parvovirus (Triple Snap + Parvo) | 7 Jul (owner request) | ALL NEGATIVE |
Clinical progression during admission:
| Date | Event |
|---|---|
| 3 Jul ~8:30 PM | Emergency admission. Complete urinary blockage. QAR, subnormal temperature, bladder non-compressible. |
| 3 Jul midnight | Closed-system urinary catheter placed due to complete obstruction. |
| 6 Jul | Cat started to develop flu β watery ocular and nasal discharge. HCT dropping (30.0%), PLT critically low (44 K/Β΅L). Significant haematuria + proteinuria + glucosuria on UA. |
| 7 Jul | Rodent ulcer (eosinophilic granuloma) noticed. Viral tests (FIV, FeLV, Parvo) performed at owner's request β all negative. |
| 8 Jul | Discharged with IV port in situ. Transferred directly to UPM Veterinary Hospital. |
Treatment during St Angel ICU admission:
| # | Drug / Intervention | Notes |
|---|---|---|
| 1 | IV fluids | ICU fluid therapy |
| 2 | Closed system urinary catheterisation | Placed midnight 3 Jul β complete blockage |
| 3 | Enrofloxacin | Empirical antibacterial (note: Pseudomonas later confirmed R to Enrofloxacin) |
| 4 | Tramadol | Pain management |
| 5 | Papase (papain enzyme) | Anti-inflammatory / mucolytic |
| 6 | Onsior (Robenacoxib) | NSAID β pain + inflammation |
| 7 | Azodyl | Renal support / uremic toxin reduction |
| 8 | Nutriplus gel blood booster | Nutritional / haematinic support |
| 9 | Vetri DMG | Immune support |
| 10 | Kaolin pectin | GI protection |
| 11 | Guardizen probiotic | GI support |
| 12 | Chloramine | Antiseptic / wound care |
| 13 | Nebulisation | Respiratory β initiated as watery nasal discharge began 6 Jul |
Discharge (8 July 2025): Discharged with IV port in place for immediate continuity of care at UPM. Urine culture (Pathlab) result to be forwarded to owner within 2 weeks.
Urine culture (Pathlab, Lab No. 36461400, collected 7 Jul, reported 12 Jul): Klebsiella spp. >100,000 org/mL. Sensitive to Amikacin only. Resistant to: Augmentin, Azithromycin, Ceftazidime, Cephalexin, Clindamycin, Ceftriaxone (I), Cefuroxime, Doxycycline, Enrofloxacin, Imipenem, Marbofloxacin, Metronidazole. Result returned after Barkoba had already transferred to UPM.
Weight: 6.65 kg (on admission/during St Angel stay) β 6.20 kg (at Dr Salina's report, 7 Jul) Β· Bill: RM 2,471.45 Β· Attending: Dr Nur Salina DVM (UPM graduate)
Admission sequence: Discharged from St Angel on 8 July 2025 afternoon β brought directly to UPM Veterinary Hospital the same day. No gap between the two admissions. IV port from St Angel maintained for continuity of care.
Admission weight: 6.10 kg (source: AMC report 30 Aug 2025 referencing UPM data)
Procedures confirmed from UPM BILL-2303: Nasogastric (NG) tube placement Β· IV fluid therapy (NaCl 0.9%, Sodium Lactate) Β· Blood culture sent Β· Urine culture sent Β· Ophthalmology examination (Tonovet IOP, Schirmer tear test, Fluorescein test) Β· Nebulisation Β· Wound dressing Β· Full medication course (see Medications section)
X-ray findings (source: AMC Medical Report, 30 Aug 2025, referencing prior UPM radiology): Mild bronchitis pattern. Bladder stones present. VHS normal.
Key diagnostics during UPM admission:
| Date | Test | Result | Source |
|---|---|---|---|
| 11 Jul 2025 | Urine culture (C&S) | Enterobacter cloacae + Pseudomonas aeruginosa | UPM lab (billed via BILL-2303) |
| Sampling kit purchased from AMC: 14 Jul 2025 Sample taken at UPM ICU (date during admission) Received by Antech: 21 Jul 2025 Reported: 29 Jul 2025 | Feline Respiratory PCR Panel (Antech, HK) β Accession# HKAA01420663 | FHV-1 POSITIVE FCV NEGATIVE Β· Influenza H1N1 NEGATIVE Β· Bordetella NEGATIVE Β· Chlamydophila NEGATIVE Β· Mycoplasma felis NEGATIVE | AMC invoice Ref 3092820, RM 750 β Β· Lab report Accession# HKAA01420663 β |
| 16 Jul 2025 | Ophthalmology β Dr Nadzariah Cheng | Corneal ulcer assessed. Bilateral mucopurulent discharge. Tonovet IOP, Schirmer tear test, Fluorescein test. | UPM BILL-2303 (procedures) + Animed invoice RM 883 (17 Jul) β |
| 17 Jul 2025 (collected) | Blood culture (Innoquest Lab No. 25-7817268) | Pseudomonas aeruginosa + Escherichia coli β bacteraemia confirmed | Innoquest lab report β (reported 21 Jul) |
| Organism | Amikacin | Imipenem | Ceftazidime | Meropenem | Tazocin | Ceftazidime-Avibactam | Tobramycin | Cefepime | Ciprofloxacin | Gentamicin | Enrofloxacin |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Org 1: Pseudomonas aeruginosa | S | S | S | S | S | S | S | S | R | R | R |
| Org 2: Escherichia coli | S | S | R | S | S | β | β | β | R | S | R |
Gram stain: Gram-negative bacilli in blood culture (peds bottle). Full resistance panel β Pseudomonas: also R to Augmentin, Cephalexin, Ceftriaxone, Levofloxacin, Doxycycline. E. coli: also R to Ampicillin, Augmentin, Cephalexin, Cefuroxime, Enrofloxacin, Marbofloxacin. Ertapenem S (E. coli). Imipenem commenced on this result.
Treatment commenced: Imipenem IV started on blood culture sensitivity result. Full medication list confirmed from UPM BILL-2303 β see Medications section (UPM).
Discharge (18 July 2025): Barkoba discharged from UPM on 18 July. Blood transfusion urgently required β donor cats cannot be brought to UPM. Transferred directly to Jawharicat the same day.
Ophthalmology note: Dr Nadzariah Cheng consulted Barkoba's eyes on 16 July 2025. Ophthalmology procedures billed through UPM invoice (Tonovet IOP, Schirmer tear test, Fluorescein test). Animed billing invoice: RM 883 dated 17 July.
Bill (UPM, BILL-2303): RM 3,264.80 total (includes RM 1,000 deposit paid on 8 July 2025, day of admission) Β· Stay duration: 8β18 July 2025 (10 days)
Note: Barkoba was still warded at UPM at this time (8β18 July). Royal Canin Recovery food commenced (Nuro Vet invoice, 10 Jul β).
11 July 2025: Owner sourced Virbagen Omega (Feline Interferon-Ο) separately and sent it to UPM for Barkoba's treatment. PCR results had not yet been received at this point β Virbagen Omega was administered based on clinical presentation.
12 July 2025 morning: Virbagen Omega administered to Barkoba at UPM ICU.
Source: owner record. Virbagen Omega was owner-sourced β not dispensed by any clinic. FHV-1 PCR result (Antech) only received 29 July; DobbyVet PCR result 22 July.
Barkoba warded at UPM ICU. Dr Nadzariah Cheng consulted Barkoba's eyes on 16 July 2025 β corneal ulcer assessment, bilateral mucopurulent discharge. Imipenem IV continued for MDR Pseudomonas + Enterobacter.
17 July 2025 β Blood type testing: Owner asked Dr Farouq about blood donor cats and arranged for blood type testing. AL-EASY blood typing kit (RM 210) purchased from Jawharicat and sent to UPM. UPM doctor performed the test on Barkoba. Result confirmed same evening β Barkoba Blood Type A.
17 July 2025 β Blood culture collected: Blood culture sample collected at UPM (Lab No. 25-7817268, Innoquest) β reported 21 July, confirmed Pseudomonas aeruginosa + E. coli bacteraemia.
17 July 2025 β Ophthalmology billing: Dr Nadzariah Cheng's ophthalmology consultation (performed 16 July) billed via Animed invoice: RM 883 (dated 17 Jul).
Morning 18 July: Owner confirmed to Dr Farouq β proceeding with transfer of Barkoba from UPM to Jawharicat for blood transfusion. Donor cats cannot be brought to UPM; transfer necessary.
Reason for discharge from UPM and transfer to Jawharicat: Blood transfusion urgently required due to critically low PCV (16%). UPM does not have resident blood donor cats, and donor cats cannot be transported to UPM. Barkoba was therefore discharged from UPM and brought directly to Jawharicat on the same day β specifically because Jawharicat has resident donor cats on-site.
PCV on 18 July (pre-transfusion): 16% β critically low (reference: 30.3β52.3%). Severe anaemia, non-regenerative.
Same-day blood transfusion β 18 July 2025 (Jawharicat, 3 resident donor cats):
| Donor Cat | Volume | Notes |
|---|---|---|
| Jawharicat Resident Cat 1 | Whole blood | Jawharicat clinic resident donor |
| Jawharicat Resident Cat 2 | Whole blood | Jawharicat clinic resident donor |
| Jawharicat Resident Cat 3 | Whole blood | Jawharicat clinic resident donor |
Blood type compatibility testing: AL-EASY kit (RM 210) purchased from Jawharicat, sent to UPM on 17 July. Barkoba confirmed Blood Type A on evening of 17 July. Transfusion from clinic resident cats on 18 July = first transfusion episode. A separate second transfusion episode occurred in early August β donors: Orked (3 Aug), Leo (3 Aug), Samsudin (4 Aug). Pablo was blood-typed but incompatible β Barkoba is blood type A, Pablo is blood type B β could not donate.
Jawharicat ICU admission (18 Jul onwards):
Week 1 medications (source: owner summary doc β no Jawharicat clinical notes PDF in Drive): Hylodual Intense eye drops TID, Alcan eye drops TID, wound dressing (Hibiscrub + antibiotic gel), Dentisept SID, Haemomaxx 2.5 ml SID, Viusid 1 ml BID, Imipenem IV Γ5 days, Stem Cell 1 cap SID, Azodyl 1 cap SID. Diet: Renal Singen.
24 Jul: Nasogastric tube removed. Improvement noted in eye and nasal septum.
Week 2 medications (source: confirmed from INV-2883 β Famciclovir 60 tabs, Dantrolene, Cetirizine, Papain, Tolfedine injection, Stemtech AFA extract all billed): Famciclovir 1 tab BID (started ~30 Jul), Imipenem IV Γ5 days, Dantrolene 1 ml BID, Cetirizine, Papain/Beazyme, Tolfedine injection, Stemtech AFA extract. [Virbagen Omega β owner-sourced separately, not dispensed by Jawharicat]
4 Aug β medications initiated: Mirtazapine 15mg/ml transdermal cream 0.4 ml daily β started in ward as appetite stimulant. Weight 5.2 kg. Temperature 38.6Β°C.
5 Aug β status: Weight 5.35 kg. Temperature 38.2Β°C. HCT recovering to 30.1% (post Samsudin transfusion). WBC improving (23.90 β 15.53).
~7 Aug β additional medications: Darbepoetin (DPO) 0.2 ml IV injection (erythropoiesis stimulator, RM 180). Wecysto Plus Gel continued.
~28 Jul blood culture result (source: owner summary doc β no lab PDF in Drive for this date): Pseudomonas cleared. Enterobacter cloacae still present β sensitive to Imipenem.
Admission bill: RM 7,540.00 (Jawharicat invoice INV-2937, billing date 19 Jul β invoice date does not represent clinical date) + RM 2,000 deposit (18 Jul) Β· UPM bill (for 8β18 Jul stay): RM 3,264.80
Weight tracking (source: owner summary doc): 18 Jul: 5.60 kg β 24 Jul: 5.30 kg β 31 Jul: 5.54 kg
Note: Two dates β 19 Jul and 21 Jul results (IDEXX ProCyte Dx + Catalyst One) β both confirmed from IDEXX printout headers, not invoice dates:
| Parameter | 21 Jul Result | 19 Jul Result | Reference | Flag |
|---|---|---|---|---|
| RBC (Γ10ΒΉΒ²/L) | 9.24 | 7.53 | 6.54β12.20 | Normal |
| HCT (%) | 45.8 | 36.1 | 30.3β52.3 | Normal |
| HGB (g/dL) | 13.8 | 11.3 | 9.8β16.2 | Normal |
| WBC (Γ10βΉ/L) | 10.67 | 20.36 | 5.5β19.5 | β Improved |
| NEU (Γ10βΉ/L) | 8.58 | 15.93 | 2.30β10.29 | β Improving |
| PLT (K/Β΅L) | 158 | 131 | 151β600 | β LOW |
| RETIC (%) | 0.5 | 0.5 | β | Very low β non-regenerative |
| SDMA (Β΅g/dL) | 35 | 26 | 0β14 | ββ HIGH |
| Creatinine (Β΅mol/L) | 186 | 284 | 71β212 | β Improving |
| Urea (mmol/L) | 12.7 | 13.2 | 5.7β12.9 | β HIGH |
| Potassium (mmol/L) | 3.3 | 2.8 | 3.5β5.8 | β LOW |
| GLOB (g/L) | 56 | 51 | 28β51 | β HIGH (inflammation) |
| ALT (U/L) | 63 | 63 | 12β130 | Normal |
SDMA note: SDMA 35 Β΅g/dL with Creatinine within reference interval β IDEXX algorithm: likely impaired GFR and kidney function. Recommended: complete urinalysis evaluation.
HCT monitoring during ICU (Aug 2025):
| Date (approx β owner notes) | HCT (%) | Ref (30.3β52.3%) | Event |
|---|---|---|---|
| ~2 Aug* | 18.2 | 30.3β52.3 | Pre-transfusion. Ultrasound: kidney stone appears resolved |
| ~3 Aug* | 17.9 | 30.3β52.3 | Blood transfusions: Orked + Leo donate (service date confirmed via Jawharicat invoice line items β 3 Aug). Pablo blood-typed β incompatible (Type B vs Barkoba Type A) β cannot donate. HCT value from owner notes. |
| 4 Aug 2025 11:24 AM β | 25.7 | 30.3β52.3 | Samsudin donates. HCT 25.7% (IDEXX confirmed). RBC 5.66, WBC 23.90 ββ, PLT 171, RETIC 0.1% non-regenerative. Source: IDEXX ProCyte Dx printout "Barkoba 5.8.2025.pdf". |
| 5 Aug 2025 11:55 AM β | 30.1 | 30.3β52.3 | Post-Samsudin transfusion. HCT 30.1% (IDEXX confirmed). RBC 8.32 (improving), WBC 15.53 (β from 23.90), PLT 207, RETIC 26.8% β regenerative response beginning. Weight 5.35 kg. Source: IDEXX ProCyte Dx printout "Barkoba 5.8.2025.pdf". |
| ~6 Aug* | 32.1 | 30.3β52.3 | Improved |
| ~7 Aug* | 22.5 | 30.3β52.3 | β HCT drops again. No blood transfusion. DPO (Darbepoetin) 0.2 ml IV administered. Mirtazapine cream initiated. Dr Farouq recommends bone marrow biopsy. Date from owner notes. |
Additional 7 Aug findings: Blood culture result: No growth on Day 3 and Day 5 incubation. Pseudomonas cleared. Enterobacter reportedly clearing.
7 Aug bill: RM 8,823.60 (discharge day β peak expenditure). Total donor transfusion cost: RM 2,710 (Orked RM 1,386 + Leo RM 1,324). Note: INV-2987 "blood transfusion recipient fee" RM 300 = procedure/administration fee, not a new donation.
Weight trend (Aug): 1 Aug: 5.38 kg β 7 Aug: 5.41 kg (slow gain).
Discharge instructions from Dr Muhammad Khayeer Al-Farouq:
Daily temperature monitoring (38.2β39.2Β°C); if >40Β°C administer antipyretic. Daily weight check. Water intake minimum 350 ml/day; subcutaneous fluid therapy 150β200 ml/day (oral + SC combination). Daily bladder palpation (ensure non-turgid). Daily urine output monitoring. Multiple cellulitis at forelimbs β daily wound dressing. Diet: Hill's k/d / Royal Canin Renal / Singen Renal Liquid.
Discharge medications: Famciclovir 1 tab SID Γ2 months, Azodyl 1 tab BID Γ2 months, Dantrolene 1 ml SID Γ20 days, Calmurofel 1 cap BID Γ15 days.
Next appointment: Full blood test 16 August 2025 (Saturday).
"After 21 days of hospitalization, with multiple times of blood transfusion, Barkoba showed a lot of improvement in terms of appetite and healing." β Dr Farouq
Owner minimised clinic visits to reduce Barkoba's stress. Multiple housecall vets engaged for blood draws (jugular), subcutaneous fluid administration, and vitals monitoring.
8β9 Aug: Nuro Vet housecall, bloodwork, subcut 100 ml, vitals. 10 Aug: Dr Ruth Lau housecall. 14 Aug: Dr Petunia housecall checkup. 19 Aug: Nuro Vet housecall + bloodwork, subcut, vitals.
Note: Specific medications prescribed during home recovery phase are documented in the Medications section under current prescriptions as per Dr Farouq's 7 August discharge instructions.
Weight: 6.15 kg. BCS: 3/9. MM: pink.
Physical exam findings: Partially recovered fungal skin infection (ongoing since 2021). Moderate calculus gingivitis. Right upper maxilla gum growth. Bilateral KCS (BUT <3 sec, mild conjunctivitis, watery eyes). Bladder: mild to moderately filled, wall mildly to moderately irregular and thickened β possible chronic mucosal changes / hyperplasia / neoplasia (to be further investigated by specialists). LN: all normal on palpation.
Thoracic radiograph (4 views): Mild to moderate bronchial pattern. VHS 7.2 (within normal limits).
ECG: HR 189 bpm. Sinus rhythm. P-wave enlargement. Low voltage ECG. Unspecific intraventricular conduction defect. ABNORMAL ECG.
Blood pressure: Systolic avg 149 mmHg (146/157/143), MAP avg 113 (120/111/108), Diastolic avg 93 (105/86/89). Systolic borderline elevated.
SpOβ: 90β100% (fluctuates during stress).
Troponin I (feline, 29 Aug): 0.05 ng/mL (Normal <0.18 ng/mL) β now normalised vs 0.65 ng/mL on 26 Jun.
NT-proBNP: <50 pmol/L (Normal <100 pmol/L).
Blood smear: Normochromic RBC morphology, anisocytosis 1+, normal leukocyte count and differential, normal platelet count, no blood parasites.
Cystocentesis urine culture: Pending (results to follow).
Skin lab analysis: Heavy cocci bacteria. Very few Malassezia.
FIP ImmunoComb: Unable to perform β inadequate sample. AMC did not request repeat. Closed.
Current active issues noted by Dr Amilan (source: AMC Medical Report Ref 1089740, Dr Amilan Sivagurunathan, 30 Aug 2025 β confirmed in Drive): MDR bacterial infection (Enterobacter recently cultured, Pseudomonas previously), chronic recurrent anaemia (>30% recurrence), chronic viral FHV/FCV, bilateral KCS, chronic pyoderma + fungal skin (since 2021), chronic cystitis, nephrolithiasis, small bladder stones, moderate gingivitis, right maxilla gum growth, urine burn hair regrowth (slow), possible inherited cardiac signs.
Planned: Cystotomy at AMC β pending further stabilisation. Not yet performed as of 9 Aug 2025.
Owner note: Proactive in contingency planning for bacteriophage therapy if Imipenem fails; inquired about shipping isolates to Canada for custom phage production.
Bill: RM 2,231.00
Bloodwork + Darbepoetin (Darbopoetin) injection to stimulate erythropoiesis. Bill: RM 662.50 (Nuro Vet invoice).
KD Vet (20 Sep): Bloodwork, urine culture, X-ray, ultrasound. RM 1,571. Key results:
RBC 4.73 (β), HCT 27.2% (β β anaemia), HGB 8.6 g/dL (β), RETIC 0.2% (non-regenerative), WBC 7.92 (normal), PLT 281 (normal), SDMA 21 Β΅g/dL (β), Creatinine 134 Β΅mol/L (WNL), Urea 8.0 (normal), UPC ratio 0.26, Potassium 4.5, Phosphorus 1.66, Calcium 2.30, Sodium 161.
Urine culture (cystocentesis, 20 Sep): E. coli >10β΅ CFU/mL.
Shinzovet Echocardiogram (20 Sep β Dr Anthony Leong β Vetcardio Services): Mild to moderate pericardial effusion noted. Mildly dilated LV. Upper-normal LV basal lateral wall (diastole: 5.55β5.79 mm). Global systolic function: Normal EF. Reduced cardiac output suspected. Echocardiogram deposit RM 200. Full report 30 Sep.
Based on 20 Sep urine culture result (E. coli >10β΅ CFU/mL, sensitive to amoxicillin-clavulanate), Augmentin (Amoxicillin-clavulanate 62.5 mg) initiated: 15 mg/kg BID Γ14 days. Urajiron (iron supplement) from AMC: RM 449.50.
Physical exam: Bright and alert. BCS 5/9. Pink MM. CRT <2s. Temp 38.2Β°C. HR 150 bpm. RR 48 bpm. BP 111/72 (83) mmHg, PR 157 bpm. Increased inspiratory noise. Weight: 6.45 kg.
Echocardiogram (M-mode): IVSd 4.20 mm, LVIDd 18.39 mm, LVIDs 11.37 mm, LVPWd 4.64 mm, LV FS 38%, LVEF (Teich) 72%, LA/Ao 1.24 (normal), LAD 13.41 mm.
Doppler: LVOT Vmax 0.75 m/s. LVOT CO: 0.43 L/min (mildly reduced). MV E/A 1.35. RVOT normal. No mitral or tricuspid regurgitation. No pulmonary hypertension.
Pericardium: Mildly thickened. Small effusion. Mild to moderate amount of hypo- to isoechoic material within pericardium (unchanged from 20 Sep).
Impression: Suspected pericardial effusion secondary to pericarditis and myocarditis from systemic infection. May explain previously elevated Troponin I. Barkoba possibly recovering from pericarditis/myocarditis.
Anaesthesia risk: ASA III. Risks: Reduced CO, pericardial effusion may trigger malignant arrhythmias, lower tolerance to perioperative fluids.
If GA required: (1) Monitor BP, HR, ECG. (2) Consider Dobutamine CRI. (3) Fluids <3 ml/kg/hr. (4) Check baseline feline SAA2 + Troponin-I pre-anaesthesia.
Treatment continued: Amoxicillin-clavulanate 15 mg/kg BID Γ14 days. Gabapentin prescribed. Bill: RM 475 (2nd appointment) + RM 515 (echocardiogram + pre-anaesthesia) = RM 990.
Procedures performed: Cystotomy (bladder stone removal), Endoscopy (sample excl. biopsy), PCCL (Percutaneous Cystolitholapaxy). Bladder tissue biopsy taken and sent to FINN Pathologists (UK).
Analgesia: Fentanyl 0.05 mg/ml injection. Onsior prescribed (3 days). Gabapentin 300 mg. Pepian Gastric (gastric protection).
Dr Sivan (Cardiology, AMC): X-ray performed (RM 120). Ultrasound (RM 380 + RM 200).
Dr Stephanie Lavania Petrus: Catalyst UPC (2), dipstick, urine culture at AMC (RM 278 + RM 270).
Total AMC bill 2 Oct: RM 4,872.30 + RM 720 (Dr Sivan) + RM 12,100 (Dr Elise β surgery + endoscopy) = RM 17,692.30 (single visit).
Post-operative care: Discharge medications and instructions per Dr Elise Robertson and AMC team. Refer to AMC invoice (Ref: 1089740, 04/10/2025) for full dispensed items.
Sample: Bladder tissue swab (from cystotomy 2 Oct). Access No: 25101333767.
Culture result β Enterococcus sp. (Growth: +++)
| Antibiotic | Result | Tier |
|---|---|---|
| Sulpha/Trimethoprim | Not reported (Enterococci have salvage pathways β appears sensitive in vitro but NOT indicated) | |
| Marbofloxacin | R | 3rd tier |
| Pradofloxacin | R | 3rd tier |
| Clindamycin | R | 2nd tier |
| Amoxicillin/Clavulanic acid | R | 2nd tier |
| Amoxicillin | R | β |
| Cephalexin | R | 2nd tier |
| Cefovecin | R | 3rd tier |
| Doxycycline | R | β |
| Ceftazidime | R | 3rd tier |
| Cefuroxime | R | 2nd tier |
| Tobramycin | R | 2nd tier |
| Gentamicin | R | 2nd tier |
| Amikacin | R | 2nd tier |
| Ticarcillin/Clavulanic Acid | R | 2nd tier |
| Piperacillin/Tazobactam | R | 3rd tier |
Histopathology (bladder biopsy): 1 tissue (wedge), multiple levels. Mucosa and submucosa absent in the biopsy β primary lesion uncertain. Muscularis unremarkable. Serosal fibro-adipose tissue: few haemosiderophages, lymphocytes and plasma cells. Diagnosis: Mild non-suppurative serosal inflammation with haemosiderosis. Comment: Consider previous mural cystitis or trauma. Neoplasia not recognised in this sample, but mucosal layer absent β cannot exclude.
Routine post-cystotomy/endoscopy monitoring. Bloodwork + urine culture and sensitivity performed. Antibiotics and Azodyl dispensed.
Bills: Diagnostics RM 791 Β· Antibiotics + Azodyl RM 245 Β· Total: RM 1,036
Source: Barkoba Finance tracker β 3 Nov 2025 entries.
Follow-up visit at One Vet Ampang. No invoice in Drive for this date β visit confirmed by folder "14. 18 Nov 2025 One Vet Ampang" in Google Drive. Specific diagnostics pending document retrieval.
Source: Google Drive folder structure β folder #14.
Monthly surveillance bloodwork and urine culture + sensitivity. Ongoing monitoring for MDR Pseudomonas infection status post-cystotomy.
Bill: RM 565 (One Vet Ampang, 3 Dec 2025)
Source: Barkoba Finance tracker β 3 Dec 2025 entry.
Ceftazidime sourcing: 7 vials β owner-sourced (RM 272.15, 13 Dec 2025).
IM injection administration:
| Date | Clinic | Cost |
|---|---|---|
| 18 Dec 2025 | Nuro Vet | RM 57.00 |
| 19 Dec 2025 | Nuro Vet | RM 108.00 |
| 20 Dec 2025 | Nuro Vet | RM 35.00 |
| 21 Dec 2025 | Nuro Vet | RM 15.00 |
| 22 Dec 2025 | Petsville | RM 10.00 |
| 23 Dec 2025 | Petsville | RM 10.00 |
| 24 Dec 2025 | Petsville | RM 10.00 |
Total Ceftazidime course cost: ~RM 517 (drug + injections)
Year-end monitoring. Full bloodwork + urine culture performed. Ongoing management protocols maintained. Cysthopan (bladder GAG supplement) added to regimen around this period.
Bill: RM 1,103.60
Source: Barkoba Finance tracker β 30 Dec 2025 entry. Drive folder: "16. 30 Dec 2025 - Teoh".
Comprehensive follow-up at UPM. CBC (IDEXX ProCyte Dx), urine culture, bladder and kidney ultrasound performed. CBC results confirm significant haematological recovery compared to crisis levels in July 2025.
CBC β 29 January 2026 (IDEXX ProCyte Dx):
| Parameter | Result | Unit | Reference | Flag |
|---|---|---|---|---|
| RBC | 8.63 | Γ10ΒΉΒ²/L | 6.54β12.20 | Normal β |
| HCT | 45.8 | % | 30.3β52.3 | Normal β |
| HGB | 14.7 | g/dL | 9.8β16.2 | Normal β |
| MCV | 53.1 | fL | 35.9β53.1 | Normal (upper limit) |
| MCH | 17.0 | pg | 11.8β17.3 | Normal β |
| MCHC | 32.1 | g/dL | 28.1β35.8 | Normal β |
| WBC | 7.41 | Γ10βΉ/L | 2.87β17.02 | Normal β |
| NEU | 3.24 | Γ10βΉ/L | 2.30β10.29 | Normal β |
| LYM | 3.42 | Γ10βΉ/L | 0.92β6.88 | Normal β |
| MONO | 0.23 | Γ10βΉ/L | 0.05β0.67 | Normal β |
| EOS | 0.46 | Γ10βΉ/L | 0.17β1.57 | Normal β |
| PLT | 282 | K/Β΅L | 151β600 | Normal β |
| MPV | 17.5 | fL | 11.4β21.6 | Normal β |
| RETIC | 12.9 | K/Β΅L | 15.0β27.0 (absolute) | β Mildly below range β monitor |
Bill: RM 773 (blood test + urine culture + ultrasound, UPM)
Source: CBC image "29Jan CBC BARKOBA.jpg" from Google Drive + Finance tracker. Drive folder: "17. 29 Jan 2026 - UPM".
Susceptibility profile β Pseudomonas aeruginosa (25 Mar 2026):
| Antibiotic | Result | Notes |
|---|---|---|
| Amikacin | S β Susceptible | Active |
| Ceftazidime | S β Susceptible | Active (previously used Dec 2025) |
| Cefepime | S β Susceptible | 4th-gen cephalosporin β active |
| Imipenem | S β Susceptible | β Primary carbapenem β STILL ACTIVE |
| Meropenem | S β Susceptible | Carbapenem option |
| Tazocin (Pip/Tazo) | S β Susceptible | Active |
| Tobramycin | S β Susceptible | Active aminoglycoside |
| Augmentin | R β Resistant | β |
| Cefuroxime | R β Resistant | β |
| Cephalexin | R β Resistant | β |
| Ciprofloxacin | R β Resistant | Fluoroquinolone resistance confirmed |
| Clindamycin | R β Resistant | β |
| Enrofloxacin | R β Resistant | Fluoroquinolone resistance confirmed |
| Gentamicin | R β Resistant | Aminoglycoside resistance |
| Metronidazole | R β Resistant | β |
| Levofloxacin | R β Resistant | Fluoroquinolone resistance |
| Doxycycline | R β Resistant | β |
| Azithromycin | R β Resistant | β |
Note: Mupirocin not tested. No CLSI guidelines available for other requested antibiotics per lab note.
Bills β 25 March 2026: AMC consultation/procedures RM 1,380 Β· Hill's c/d Multicare Stress Kibbles 1.5kg Γ6 RM 804 Β· Azodyl Γ2 RM 820 Β· Misc RM 277.19
31 March 2026 β AMC follow-up: RM 1,911 (details not yet in Drive)
Source: "25 MARCH 2026 AMC URINE CULTURE" PDF + Finance tracker. Lab No. 26-8265495 reported 28 Mar 2026.
| Date | Activity | Estimated Cost | Rule / Remarks |
|---|---|---|---|
| 2 May 2026 | Full blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC, urine culture | RM 655 + UPC | Baseline before Injection 1 |
| 9 May 2026 | Stem cell product cycle 1 + Injection 1 | RM 1,370 + injection fee | Covers Injections 1 and 2 |
| 23 May 2026 | Reduced blood: CBC, renal, SDMA, electrolytes, urinalysis, urine USG | RM 505 + urinalysis | Pre-Injection 2 checkpoint β review same day |
| 24 May 2026 | Injection 2 | Injection fee separate | Proceed only if clinically stable |
| 6 June 2026 | Stem cell product cycle 2 + Injection 3 | RM 1,370 + injection fee | Covers Injections 3 and 4 |
| 19 June 2026 | Full blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC, urine culture | RM 655 + UPC | Monthly microbiology checkpoint β major decision point |
| 20 June 2026 | Injection 4 | Injection fee separate | Continue only if measurable benefit confirmed |
| 4 July 2026 | Stem cell product cycle 3 + Injection 5 | RM 1,370 + injection fee | Covers Injections 5 and 6 |
| 17 July 2026 | Reduced blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC | RM 505 + UPC + urinalysis | Final pre-Injection 6 review |
| 18 July 2026 | Injection 6 | Injection fee separate | Final biologic phase |
| Monthly (post first no-growth) | Urine culture | RM 150 each | Continue until 3 consecutive no-growth results |
| Flexible | AMC review with Dr Stephanie (current primary doctor) β as and when clinically indicated | AMC fee separate | Consulted on plan β available for review based on clinical need |
Source: "Barkoba_Version_4_0_Final_Master_Schedule.docx" β uploaded to Google Drive 27 April 2026. Status: ACTIVE β first appointment scheduled 2 May 2026.
| Parameter (Unit) | Ref Range | 6 Jun 25 Petsville |
26 Jun 25 Jawharicat |
3 Jul 25 11:19PM St Angel |
6 Jul 25 11:33AM St Angel |
~Jul 25* UPM (date unconfirmed) |
19 Jul 25 Jawharicat |
21 Jul 25 Jawharicat |
3 Aug 25 Jawharicat (owner record) |
4 Aug 25 11:24AM Jawharicat IDEXX confirmed |
5 Aug 25 11:55AM Jawharicat IDEXX confirmed |
20 Sep 25 KD Vet |
30 Dec 25 Teoh Clinic |
|||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RBC (Γ10ΒΉΒ²/L or Γ10βΆ/mmΒ³) | 6.54β12.20 | 11.27 β | 9.55 | 7.01 | 6.41 β | 6.70 | β | 9.24 | β | 5.66 β | 8.32 | 4.73 β | 7.65 | |||
| HCT / PCV (%) | 30.3β52.3 | 57.3 β | 43.4 | 29.0 β | 30.0 β | 0.30 (30%) | 36.1 | 45.8 | 19.4 ββ | 25.7 ββ | 30.1 β | 27.2 β | 37.9 | |||
| HGB (g/dL) | 9.8β16.2 | 18.8 β | 14.5 | 10.9 | 9.6 β | 106 g/L | 11.3 | 13.8 | β | β | β | β | β | β | 8.6 β | 13.0 |
| MCV (fL) | 35.9β53.1 | 51 | 45.4 | 41.4 | 46.8 | 45 | 47.9 | 49.6 | β | β | β | β | β | β | 57.5 β | 49.5 |
| MCH (pg) | 11.8β17.3 | 16.7 | 15.2 | 15.5 | 15.0 | β | 15.0 | 14.9 | β | β | β | β | β | β | 18.2 β | 17.0 |
| MCHC (g/dL) | 28.1β35.8 | 32.8 | 33.4 | 37.6 | 32.0 | 353 g/L | 30.1 | 31.3 | β | β | β | β | β | β | 31.6 | 34.3 |
| RDW (%) | 15.0β27.0 | 16.3 | 23.3 | 20.9 | 20.8 | 16 | 26.7* | β | β | β | β | β | β | β | 22.1 | 21.3 |
| RETIC (%) | β | β | 0.1 | 0.1 | 0.1 | 0.1 | 0.1 | 0.5 | β | β | β | β | β | β | 0.2 (non-regen) | 0.3 |
| WBC (Γ10βΉ/L) | 5.5β19.5 | 5.7 | 9.28 | 8.87 | 11.92 | 28.20 ββ | 20.36 β | 10.67 | β | β | β | β | β | β | 7.92 | 8.79 |
| NEU (Γ10βΉ/L) | 2.30β10.29 | 3.50 (GRA) | 6.32 | 1.41 | 6.33 | 21.43 ββ + Band 3.38 | 15.93 β | 8.58 | β | β | β | β | β | β | 4.59 | 4.26 |
| LYM (Γ10βΉ/L) | 0.92β6.88 | 2.10 | 2.32 | 5.81 | 4.74 | 1.41 β | 4.35 | 1.19 | β | β | β | β | β | β | 2.69 | 3.92 |
| MONO (Γ10βΉ/L) | 0.05β0.67 | 0.10 | 0.20 | 1.42 | 0.63 | 1.97 β | 0.62 | 0.52 | β | β | β | β | β | β | 0.38 | 0.23 |
| EOS (Γ10βΉ/L) | 0.17β1.57 | 0.25 | 0.38 | 0.10 | 0.08 | 0.00 β | 0.14 | 0.09 | β | β | β | β | β | β | 0.17 | 0.34 |
| PLT (K/Β΅L or Γ10βΉ/L) | 151β600 | 221 | 239 | 180 | 44 ββ CRITICAL | 192 β | 131 | 158 | β | β | β | β | β | β | 281 | 335 |
| MPV (fL) | 11.4β21.6 | 8.3 | 16.1 | 16.2 | 21.7 β | 25.8 β | β | β | β | β | β | β | β | β | 17.2 | 16.7 |
Aug 2025 sources: 3 Aug HCT 19.4% from owner record. 4 Aug and 5 Aug: IDEXX ProCyte Dx printout "Barkoba 5.8.2025.pdf" (Jawharicat, Dr Farouq). 4 Aug 11:24 AM = previous run column; 5 Aug 11:55 AM = main run column. Other Aug dates not in Drive.
| Parameter (Unit) | Ref Range | 6 Jun 25 Petsville |
28 Jun 25 Petsville |
26 Jun 25 Jawharicat |
3 Jul 25 St Angel |
~Jul 25* UPM (date unconfirmed) |
19 Jul 25 Jawharicat |
21 Jul 25 Jawharicat |
29 Aug 25 AMC |
20 Sep 25 KD Vet |
30 Dec 25 Teoh Clinic |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GLU / Glucose | 4.11β8.84 mmol/L 74β152 mg/dL |
125 mg/dL | 238 mg/dL ββ | 12.94 mmol/L ββ | 14.0β158 mg/dL | 3.1β7.2 (NR) | 5.28 mmol/L | 6.53 mmol/L | β | 5.66 mmol/L | 5.85 mmol/L |
| SDMA (Β΅g/dL) | 0β14 | >100 ββ | β | 12 | β | β | 26 β | 35 ββ | β | 21 β | 15 β |
| CREA / Creatinine | 71β212 Β΅mol/L 0.7β2.1 mg/dL |
1.6 mg/dL | 1.2 mg/dL | 174 Β΅mol/L | 1.5 mg/dL | 232 Β΅mol/L β | 284 Β΅mol/L β | 186 Β΅mol/L | β | 134 Β΅mol/L | 171 Β΅mol/L |
| UREA / BUN | 5.7β12.9 mmol/L 15β37 mg/dL |
30.2 mg/dL | 17.0 mg/dL | 8.9 mmol/L | 18 mg/dL | 30.3 mmol/L ββ | 13.2 mmol/L | 12.7 mmol/L β | β | 8.0 mmol/L | 11.4 mmol/L |
| PHOS / Phosphate (mmol/L) | 1.00β2.42 | 3.7 mg/dL | β | 0.55 β | β | 1.1 | 1.38 | 1.80 | β | 1.66 | 1.52 |
| CA / Calcium (mmol/L) | 1.95β2.83 | 11.1 mg/dL | β | 2.69 | β | 2.2 | 2.43 | 2.51 | β | 2.30 | 2.48 |
| TP / Total Protein (g/L) | 57β89 | 8.3 g/dL β | 7.7 g/dL | 88 | 6.6 g/dL | 86.4 β | 76 | 82 | β | 77 | 78 |
| ALB / Albumin (g/L) | 22β40 | 3.6 g/dL | 3.1 g/dL | 28 | 2.3 g/dL β | 24.3 β | 25 | 26 | β | 29 | 31 |
| GLOB / Globulin (g/L) | 28β51 | 4.7 g/dL | 4.6 g/dL | 57 β | 4.4 g/dL | 62.1 ββ | 51 | 56 β | β | 48 | 47 |
| ALT (U/L) | 12β130 | 64 | 69 | 85 | 88 | 69 | 63 | 63 | β | 64 | 77 |
| ALKP / ALP (U/L) | 14β111 | 62 | 60 | β | 20 | 39 | 39 | 32 | β | 31 | 36 |
| GGT (U/L) | 0β4 | 0 | β | 4 | β | 3.6 | 1 | 0 | β | 0 | 3 |
| TBIL / Bilirubin | 0β15 Β΅mol/L | 0.15 mg/dL | β | 7 Β΅mol/L | β | β | 9 Β΅mol/L | 9 Β΅mol/L | β | <2 Β΅mol/L | 4 Β΅mol/L |
| CHOL / Cholesterol (mmol/L) | 1.68β5.81 | 208 mg/dL | β | 5.77 | β | β | 5.71 | 5.30 | β | 3.15 | 5.21 |
| AMYL / Amylase (U/L) | 500β1500 | 1433 β | β | 1104 | β | β | 901 | 784 | β | 1307 | 1233 |
| LIPA / Lipase (U/L) | 100β1400 | <20 | β | 351 | β | β | 229 | 303 | β | 489 | 465 |
| Na / Sodium (mmol/L) | 150β165 | β | β | 163 | β | 157.7 β | 166 | 163 | β | 161 | 165 (upper limit) |
| K / Potassium (mmol/L) | 3.5β5.8 | β | β | 3.8 | β | 3.7 β | 2.8 ββ | 3.3 β | β | 4.5 | 3.7 |
| Cl / Chloride (mmol/L) | 112β129 | β | β | 122 | β | 118.7 | 129 | 125 | β | 121 | 123 |
| UPC Ratio | <0.4 (cats) | β | β | 0.06 | β | β | β | β | β | 0.26 | β |
| TT4 / Thyroxine (nmol/L) | 10β60 | β | β | β | β | β | β | β | β | 22 | 18 |
Sources: Petsville Element DC, Jawharicat/KD Vet/St Angel IDEXX Catalyst One, UPM Veterinary Laboratory (Haemogram), AMC, Teoh Clinic IDEXX. Unit conversions applied where labs used different unit systems.
| Parameter | Reference | 26 Jun 2025 β Jawharicat | 29 Aug 2025 β AMC (Dr Amilan) | Interpretation |
|---|---|---|---|---|
| Troponin I (fTnI) | <0.18 ng/mL Normal 0.18β0.28 Equivocal >0.28 Abnormal |
0.65 ng/mL ββ ABNORMAL | 0.05 ng/mL β Normal | Normalised by 29 Aug. Cardiologist (Shinzovet): likely reflects myocarditis/pericarditis secondary to systemic infection at Jun time point. |
| NT-proBNP | <100 pmol/L Normal | <50 pmol/L β Normal | <50 pmol/L β Normal | No evidence of congestive heart failure at either time point. |
Echocardiogram 30 Sep 2025 (Shinzovet β Dr Anthony Leong): Pericardial effusion confirmed. LVEF 72% (normal). CO 0.43 L/min (mildly reduced). See Cardiology section for full measurements.
| Date | HCT / PCV (%) | Source | Clinical Context |
|---|---|---|---|
| 6 Jun 2025 | 57.3% β | Petsville β IDEXX CBC (INV-064574) | Haemoconcentration / dehydration. First bloodwork. |
| 26 Jun 2025 | 43.4% | Jawharicat β IDEXX ProCyte Dx | Normal. Cardiac panel + urine culture visit. |
| 3 Jul 2025 11:19 PM | 29.0% β | St Angel β IDEXX ProCyte Dx (emergency admission) | Below normal on emergency admission. Non-regenerative. |
| 6 Jul 2025 11:33 AM | 30.0% β | St Angel β IDEXX ProCyte Dx | Borderline. PLT critically low (44). Flu symptoms developing. |
| 18 Jul 2025 | 16% (PCV manual) | UPM / Jawharicat β PCV on discharge/admission | Critically low. Transferred to Jawharicat same day for blood transfusion. |
| 19 Jul 2025 | 36.1% | Jawharicat β IDEXX ProCyte Dx (confirmed printout) | Post first transfusion (18 Jul). Recovery. |
| 21 Jul 2025 | 45.8% | Jawharicat β IDEXX ProCyte Dx (confirmed printout) | Within normal range. Full blood panel. |
| 22β31 Jul 2025 | Not yet in Drive | Jawharicat β IDEXX printouts not yet uploaded | Multiple CBCs run (INV-2883: 3 CBCs). Transfusions by Orked + Leo (3 Aug) and Samsudin (4 Aug) indicate HCT dropped critically. Upload IDEXX printouts to confirm values. |
| 4 Aug 2025 11:24 AM | 25.7% ββ | Jawharicat β IDEXX ProCyte Dx β Confirmed printout in Drive ("Barkoba 5.8.2025.pdf") | Pre-Samsudin transfusion. RBC 5.66. WBC 23.90 ββ HIGH (severe inflammation/infection). PLT 171. RETIC 0.1% (non-regenerative). Monocytosis noted. |
| 5 Aug 2025 11:55 AM | 30.1% β | Jawharicat β IDEXX ProCyte Dx β Confirmed printout in Drive ("Barkoba 5.8.2025.pdf") | Post-transfusion recovery. RBC 8.32. WBC 15.53 (improving). PLT 207. RETIC 26.8% β regenerative response beginning. Weight 5.35 kg. |
| 6β7 Aug 2025 | Not yet in Drive | Jawharicat β IDEXX printouts not yet uploaded | INV-2987 confirms 4 more CBCs run. DPO injection given ~7 Aug. Upload printouts to confirm values. |
| 20 Sep 2025 | 27.2% β | KD Vet β IDEXX (invoice K2436660) | Still anaemic. Non-regenerative (RETIC 0.2%). |
| 29 Jan 2026 | 45.8% β | UPM β IDEXX ProCyte Dx (confirmed printout in Drive) | Fully normalised. Anaemia resolved. |
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| RTE# (Renal Tubular Epithelial) | 10.60 /uL | 0 /uL | ββ TUBULAR STRESS |
| SEC# (Squamous Epithelial) | 8.06 /uL | 0β7 /uL | β UTI inflammation |
| HYA# (Hyaline cast) | 0.33 /uL | 0β0.8 /uL | Normal |
| RBC# | 9.33 /uL | 0β25 /uL | Normal |
| WBC# | 7.21 /uL | 0β25 /uL | Normal |
| Crystals | None detected | β | Clear |
| Parameter | Result | Flag / Note |
|---|---|---|
| Nitrite | POSITIVE | Bacterial infection suspected |
| Leukocytes | Trace (25) | Inflammation or infection |
| Specific Gravity | 1.060 | Highly concentrated urine |
| pH | 6 | Slightly acidic |
| Urobilinogen | 4 | Mildly elevated |
| Ascorbic Acid | 40 mg/dL | High β may interfere with strip readings |
| Occult Blood, Bilirubin, Protein, Ketone, Glucose | Normal (0) | WNL |
Microscopy: Calcium phosphate crystals, calcium oxalate (insoluble β non-dissolvable), minor struvite, bacteria suspected.
| Parameter | 6 Jun 2025 | 21 Jul 2025 | Reference | Trend |
|---|---|---|---|---|
| RBC (Γ10βΆ/mmΒ³) | 11.27 | 9.24 | 5.0β10.0 (Petsville) / 6.54β12.20 (IDEXX) | β Normalised |
| HCT (%) | 57.3 | 45.8 | 27β47% / 30.3β52.3% | β Improved |
| HGB (g/dL) | 18.8 | 13.8 | 8β17 / 9.8β16.2 | β Normalised |
| WBC (Γ10Β³/mmΒ³) | 5.7 | 10.67 | 5.0β11.0 | Normal both dates |
| PLT (Γ10Β³/mmΒ³) | 221 | 158 | 180β430 / 151β600 | β Borderline low Jul |
| CREA (mg/dL / Β΅mol/L) | 1.6 mg/dL | 186 Β΅mol/L | 0.7β2.1 / 71β212 | Normal both dates |
| BUN / Urea (mg/dL / mmol/L) | 30.2 | 12.7 mmol/L | 15β37 / 5.7β12.9 | β Borderline Jul |
| SDMA (Β΅g/dL) | >100 | 35 | 0β14 | Still elevated (β from >100) |
| KβΊ (mmol/L) | β | 3.3 | 3.5β5.8 | β LOW (hypokalemia) |
| GLOB (g/L / g/dL) | 4.7 | 56 g/L | 3.0β5.7 / 28β51 | β Persistent (inflammation) |
| TP (g/dL / g/L) | 8.3 | 82 g/L | 5.0β8.2 / 57β89 | Normalised |
| AMY (U/L) | 1433 | 784 | 500β1400 / 500β1500 | β Normalised |
| Parameter | Result | Reference | Flag |
|---|---|---|---|
| RBC | 4.73 | 6.54β12.20 Γ10ΒΉΒ²/L | β ANAEMIA |
| HCT (%) | 27.2 | 30.3β52.3 | β BELOW NORMAL |
| HGB (g/dL) | 8.6 | 9.8β16.2 | β ANAEMIA |
| RETIC (%) | 0.2 | β | Non-regenerative pattern |
| WBC (Γ10βΉ/L) | 7.92 | 5.5β19.5 | Normal |
| PLT (K/Β΅L) | 281 | 151β600 | Normal |
| SDMA (Β΅g/dL) | 21 | 0β14 | β Kidney concern |
| Creatinine (Β΅mol/L) | 134 | 71β212 | WNL |
| Urea (mmol/L) | 8.0 | 5.7β12.9 | Normal |
| UPC ratio | 0.26 | <0.4 normal | Normal |
| Potassium (mmol/L) | 4.5 | 3.5β5.8 | Normal |
| Phosphorus (mmol/L) | 1.66 | 0.8β2.2 | Normal |
| Parameter | Result | Unit | Reference | Flag |
|---|---|---|---|---|
| RBC | 8.63 | Γ10ΒΉΒ²/L | 6.54β12.20 | Normal β |
| HCT | 45.8 | % | 30.3β52.3 | Normal β β anaemia fully resolved (was 27.2% Sep 2025, 29.0% Jul 2025) |
| HGB | 14.7 | g/dL | 9.8β16.2 | Normal β |
| MCV | 53.1 | fL | 35.9β53.1 | Normal (upper limit) |
| MCH | 17.0 | pg | 11.8β17.3 | Normal β |
| MCHC | 32.1 | g/dL | 28.1β35.8 | Normal β |
| WBC | 7.41 | Γ10βΉ/L | 2.87β17.02 | Normal β |
| NEU | 3.24 (43.7%) | Γ10βΉ/L | 2.30β10.29 | Normal β |
| LYM | 3.42 (46.2%) | Γ10βΉ/L | 0.92β6.88 | Normal β |
| MONO | 0.23 (3.1%) | Γ10βΉ/L | 0.05β0.67 | Normal β |
| EOS | 0.46 (6.2%) | Γ10βΉ/L | 0.17β1.57 | Normal β |
| PLT | 282 | K/Β΅L | 151β600 | Normal β β fully recovered (was 44 on 6 Jul 2025 crisis) |
| MPV | 17.5 | fL | 11.4β21.6 | Normal β |
| RETIC (absolute) | 12.9 | K/Β΅L | 15.0β27.0 | β Mildly below range β continue monitoring |
| RETIC (%) | 0.2 | % | 3.0β50.0 | Low percentage β regeneration mildly blunted |
Source: "29Jan CBC BARKOBA.jpg" (IDEXX ProCyte Dx printout, 29 Jan 2026 11:38 AM). All haematological parameters essentially normal. This represents full recovery from the JulβSep 2025 anaemia and thrombocytopenia crisis.
| Date | Troponin I (feline) | Reference | NT-proBNP | Reference |
|---|---|---|---|---|
| 26 Jun 2025 (Jawharicat) | 0.65 ng/mL | <0.06 (IDEXX feline) | <50 pmol/L | <100 pmol/L |
| 29 Aug 2025 (AMC) | 0.05 ng/mL | <0.18 ng/mL | <50 pmol/L | <100 pmol/L |
Note: Troponin normalised by 29 Aug 2025. Cardiologist (Dr Anthony Leong, Shinzovet) interpretation: Barkoba was likely recovering from myocarditis/pericarditis secondary to systemic bacterial infection at time of elevated reading.
| Collection Date | Specimen | Lab / Lab No. | Referring Clinic / Doctor | Organism | CFU/mL or Count |
|---|---|---|---|---|---|
| 26 Jun 2025 | Urine β free catch | Innoquest 25-1801854 | Jawharicat β Dr Khayeer | No growth | β |
| 7 Jul 2025 | Urine | Pathlab 36461400 | St Angel β Dr Ding Chee Min | Klebsiella spp. | >100,000 org/mL |
| 11 Jul 2025 | Urine | UPM 25-8845878 | UPM β Timbalan Dekan | Enterobacter cloacae | >10β΅ CFU/mL |
| 11 Jul 2025 | Urine | UPM 25-8845878 | UPM β Timbalan Dekan | Pseudomonas aeruginosa | 10β΄β10β΅ CFU/mL |
| 17 Jul 2025 | Blood culture | Innoquest/UPM 25-7817268 | UPM β Timbalan Dekan | Pseudomonas aeruginosa | Isolated (bacteraemia) |
| 17 Jul 2025 | Blood culture | Innoquest/UPM 25-7817268 | UPM β Timbalan Dekan | Escherichia coli | Isolated (bacteraemia) |
| 22 Jul 2025 | Urine | Innoquest 25-8843460 | Jawharicat β Dr Khayeer | Enterobacter cloacae | 10β΄β10β΅ CFU/mL |
| 22 Jul 2025 | Nasal swab | Innoquest 25-1631664 | Jawharicat β Dr Khayeer | Staphylococcus aureus | Scanty growth |
| 29 Jul 2025 | Blood culture | Innoquest 25-1446172 | Jawharicat β Dr Khayeer | No growth after 5 days | β |
| 2 Aug 2025 | Urine | Innoquest 25-1702467 | Jawharicat β Dr Khayeer | Enterococcus faecium | 10β΄β10β΅ CFU/mL |
| 20 Sep 2025 | Urine β cystocentesis | Innoquest 25-2150233 | KD Vet β Dr Tan Zhang Jian | Escherichia coli | >10β΅ CFU/mL |
| 2 Oct 2025 | Urine | Innoquest 25-2166356 | AMC β Dr Sivagurunathan | Enterococcus faecium | 10β΄β10β΅ CFU/mL |
| 2 Oct 2025 | Bladder tissue swab | FINN Pathologists UK 25101333767 | AMC β Dr Elise Robertson | Enterococcus sp. | Growth +++ |
| 3 Nov 2025 | Urine | Innoquest 25-1509491 | One Ampang β Dr Lau Sang Sang | Escherichia coli | >10β΅ CFU/mL |
| 2 Dec 2025 | Urine | Innoquest 25-2550647 | One Ampang β Dr Lau Sang Sang | Pseudomonas aeruginosa | >10β΅ CFU/mL |
| 30 Dec 2025 | Urine | Innoquest 25-2623071 | Teoh Animal Clinic β Dr Teoh Hun Pin | Pseudomonas aeruginosa | >10β΅ CFU/mL |
| 25 Mar 2026 | Urine | Innoquest 26-8265495 | AMC β Dr Sivagurunathan | Pseudomonas aeruginosa | >10β΅ CFU/mL |
| Antibiotic | Klebsiella Urine 7 Jul 25 |
E.cloacae+ Pseudo Urine 11 Jul |
Pseudo Blood 17 Jul 25 |
E. coli Blood 17 Jul 25 |
E.cloacae Urine 22 Jul 25 |
S.aureus Nasal 22 Jul 25 |
E.faecium Urine 2 Aug 25 |
E. coli Urine 20 Sep 25 |
E.faecium Urine 2 Oct 25 |
E. coli Urine 3 Nov 25 |
Pseudo Urine 2 Dec 25 |
Pseudo Urine 30 Dec 25 |
Pseudo Urine 25 Mar 26 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Amikacin | S | S / S | S | S | S | β | β | β | R | β | S | S | S |
| Imipenem | R | I / S | S | S | S | β | β | S | β | β | S | S | S |
| Meropenem | β | β | S | S | β | β | β | S | β | β | S | S | S |
| Ceftazidime | R | S / β | S | R | β | β | β | β | R | β | S | S | S |
| Tazocin | β | β | S | S | β | β | β | β | R | β | S | S | S |
| Cefepime | β | S / β | S | S | β | β | β | β | β | β | S | S | S |
| Tobramycin | β | S / β | S | β | β | β | β | β | β | β | S | S | S |
| Ceftaz-Avibactam | β | β | S | β | S | β | β | β | β | β | β | β | β |
| Augmentin | R | R / R | R | R | R | β | R | S | R | S | R | R | R |
| Ciprofloxacin | R | R / R | R | R | R | β | R | R | R | R | R | R | R |
| Enrofloxacin | R | R / R | R | R | β | β | β | R | β | β | β | R | R |
| Gentamicin | β | R / R | R | S | R | R | β | S | R | β | R | R | R |
| Levofloxacin | β | R / β | R | β | R | β | β | β | β | β | R | R | R |
| Doxycycline | R | β | R | R | β | S | β | S | S | S | R | R | R |
| Nitrofurantoin | β | R / R | β | β | R | β | S | S | S | S | β | R | β |
| Vancomycin | β | β | β | β | β | S | S | R | S | β | β | R | β |
| Linezolid | β | β | β | β | β | S | S | R | S | β | β | R | β |
| Sulph/Trimethoprim | β | R / β | β | β | R | S | β | S | β | S | R | R | β |
| Ampicillin/Sulbactam | β | R / β | β | β | R | β | R | S | R | S | β | R | β |
| Marbofloxacin | R | β | R | β | β | β | β | R | β | β | β | β | β |
| Fos/Tro (Fosfomycin) | β | β | β | β | β | β | β | S | β | S | β | β | β |
| Ertapenem | β | β | S | β | R | β | β | β | β | β | β | β | β |
| Colistin | β | β | β | β | β | β | β | β | β | β | β | I | β |
| Rifampicin | β | β | β | β | β | S | β | β | β | β | β | β | β |
| Fusidic Acid | β | β | β | β | β | S | β | R | β | β | β | R | β |
| Minocycline | β | β | β | β | β | β | β | S | β | β | β | β | β |
| Penicillin | β | β | β | β | β | R | R | R | R | β | β | β | β |
S = Susceptible | I = Intermediate | R = Resistant | β = Not tested. For Urine 11 Jul col: format = Enterobacter / Pseudomonas result. Sources: Innoquest Pathology, UPM Vet Lab, Pathlab, FINN Pathologists UK.
| Parameter | 27 Apr 25 Nurovet | 18 Jun 25 Petsville | 26 Jun 25 Innoquest | 11 Jul 25 UPM | 22 Jul 25 Innoquest | 2 Aug 25 Innoquest | 29 Aug 25 AMC | 20 Sep 25 KD Vet | 2 Oct 25 AMC | 3 Nov 25 One Ampang | 2 Dec 25 One Ampang | 30 Dec 25 Teoh | 25 Mar 26 AMC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SG | β | 1.060 | 1.020 | 1.030 | 1.030 | 1.018 | 1.013 | 1.010 | 1.017 | 1.015 | 1.010 | 1.009 | 1.010 |
| pH | β | 6.0 | 8.0 | 6.0 | 8.0 | 8.0 | 5.0 | 6.0 | 7.0 | 6.0 | 5.0 | 6.5 | 6.0 |
| Nitrite | β | Positive | Negative | Negative | Negative | Negative | Negative | Positive | Positive | Positive | Positive | Positive | Positive |
| Leucocytes | 7.21/uL | Trace(25) | Β± | +++ | +++ | +++ | 3+ | ++ | ++ | +++ | + | +++ | ++ |
| Blood | 9.33/uL | Negative | +++++ | +++++ | +++++ | ++++ | 1+ | +++ | Negative | ++++ | +++++ | ++++ | +++ |
| Protein | β | Negative | Nil | +++ | +++ | ++ | 1+ | Negative | + | +++ | + | + | + |
| WBC Microscopy | 7.21/uL | β | 15Γ10βΆ/L | >500Γ10βΆ/L | >500Γ10βΆ/L | >500Γ10βΆ/L | Numerous | 423Γ10βΆ/L | 75Γ10βΆ/L | >500Γ10βΆ/L | 20Γ10βΆ/L | >500Γ10βΆ/L | 89Γ10βΆ/L |
| RBC Microscopy | 9.33/uL | β | >250Γ10βΆ/L | >250Γ10βΆ/L | >250Γ10βΆ/L | >250Γ10βΆ/L | β | 53Γ10βΆ/L | 0 | >250Γ10βΆ/L | >250Γ10βΆ/L | 31Γ10βΆ/L | 23Γ10βΆ/L |
| Bacteria | None seen | Bacteria | β | β | β | β | Few cocci + heavy bacilli | Numerous | Moderate | Numerous | Numerous | Moderate | Numerous |
| Colour/Clarity | Yellow/Clear | β | Yellow/Sl.Turbid | Brown/Turbid | Yellow/Turbid | Yellow/Sl.Turbid | Sl.cloudy | Yellow/Clear | Pale Yel/Sl.Turbid | Pale Yel/Sl.Turbid | Pale Yel/Sl.Turbid | Yellow/Sl.Turbid | Pale Yel/Clear |
| Test | Date | Facility | Result |
|---|---|---|---|
| Feline Respiratory PCR Panel (Antech) β FHV-1 + FCV Combo 5in1 | 14 Jul 2025 | AMC β Dr Amilan (invoice Ref: 3092820) | POSITIVE β FHV-1 & Calicivirus |
| Herpes & Calicivirus PCR Combo | 22 Jul 2025 | DobbyVet (invoice RM 400) | POSITIVE β confirmed |
| Feline Triple Snap (FIV / FeLV) | 7 Jul 2025 | St Angel β Dr Nur Salina | NEGATIVE |
| Feline Parvovirus Antigen | 7 Jul 2025 | St Angel β Dr Nur Salina | NEGATIVE |
| FIP ImmunoComb | 29 Aug 2025 | AMC β Dr Amilan | Unable to perform β inadequate sample. Not repeated. Closed. |
| Felisine paste (FCoV antigen stimulant) | β | AMC β Dr Amilan (30 Aug 2025) | Considered but NOT prescribed β per Dr Amilan's report: "Owner was concerned about felisine paste effects for FCOV β hence not prescribed." |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Cystopro | Γ10 | Nuro Vet INV-6646, 27 Apr 2025 | Urinary support |
| UTI-OXI | Γ7 | Nuro Vet INV-6646, 27 Apr 2025 | Urinary antibacterial supplement |
| Denzo | Γ14 | Nuro Vet INV-6646, 27 Apr 2025 | Urinary support |
| Royal Canin Recovery | β | Nuro Vet, 10 Jul 2025 | Nutritional recovery diet |
| Darbepoetin (Darbopoetin) injection | β | Nuro Vet invoice, 11 Sep 2025 | Erythropoiesis stimulator (non-regenerative anaemia) |
| Ceftazidime IM injections | Daily IM | Nuro Vet invoices, 18β21 Dec 2025 | MDR gram-negative bacterial infection |
| Hypermix / Abscess cream | β | Nuro Vet, 10 Oct 2025 | Wound / skin management |
| Augmentin + Fecal bottle | β | Nuro Vet, 25 Sep 2025 | Bacterial infection (E. coli) |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Azodyl capsule | Γ8 | Petsville INV-064574, 6 Jun 2025 | CKD / uremic toxin reduction |
| Calmurofel capsule | Γ10 | Petsville INV-064574, 6 Jun 2025 | Bladder mucosal support |
| Clavaseptin 62.5mg | Γ16 | Petsville INV-064574, 6 Jun 2025 | Empirical antibacterial (UTI) |
| Papain Beazyme tablet | Γ8 | Petsville INV-064574, 6 Jun 2025 | Digestive / anti-inflammatory enzyme |
| Royal Canin Urinary S/O 3.5kg | 1 bag | Petsville INV-064574, 6 Jun 2025 | Prescription urinary diet |
| Azodyl capsule | Γ10 | Petsville INV-064971, 18 Jun 2025 | CKD |
| Calmurofel capsule | Γ10 | Petsville INV-064971, 18 Jun 2025 | Bladder support |
| Clavaseptin 62.5mg | Γ16 | Petsville INV-064971, 18 Jun 2025 | Antibacterial |
| Bactigen Eye Drops | Γ1 | Petsville INV-064971, 18 Jun 2025 | Eye infection (bacterial) |
| Royal Canin Renal + RC Urinary SO Pouch | β | Petsville INV-064971, 18 Jun 2025 | CKD + urinary prescription diet |
| Diazepam 0.5mg oral | Γ4 days BID | Petsville INV-065465, ward 28 Junβ3 Jul 2025 | Smooth muscle relaxant (urethral spasm) |
| Dexamethasone injection | 0.6ml IM single dose | Petsville INV-065465, ward JunβJul 2025 | Anti-inflammatory |
| Marbofloxacin injection | 1ml SQ single dose | Petsville INV-065465, ward JunβJul 2025 | Empirical antibacterial (later confirmed R) |
| Baytril / Enrofloxacin oral | 0.75 tab SID Γ8 days | Petsville INV-065465 / referral letter, Jul 2025 | Empirical antibacterial (later confirmed R to Pseudomonas) |
| Prednisolone oral | 1 tab SID Γ8 days | Petsville INV-065465 / referral letter, Jul 2025 | Anti-inflammatory |
| Prednisolone injection | Single dose | Petsville INV-065465, ward Jul 2025 | Anti-inflammatory |
| Tolfenamic Acid injection | Single dose | Petsville INV-065465, ward Jul 2025 | Antipyretic + anti-inflammatory |
| Calmurofel (extended) | Γ10 extra | Petsville discharge, 3 Jul 2025 | Bladder mucosal support |
| Azodyl | Γ10 | Petsville INV-065465, ward Jul 2025 | CKD |
| Augmentin (Amoxicillin-clav) | β | Petsville, 25 Sep 2025 | Bacterial infection |
| Ceftazidime IM injections | Daily IM | Petsville invoices, 22β24 Dec 2025 | MDR gram-negative bacterial infection |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Azodyl | Γ10 | St Angel INV-47242, 3β8 Jul 2025 | CKD |
| Painkiller (unspecified) | β | St Angel INV-47242, 3β8 Jul 2025 | Analgesia (urinary obstruction) |
| Anti-inflammatory (unspecified) | Γ9 | St Angel INV-47242, 3β8 Jul 2025 | Inflammation |
| Antibiotic (unspecified) | Γ0.75 | St Angel INV-47242, 3β8 Jul 2025 | Empirical antibacterial |
| Antihistamine (unspecified) | Γ1.5 | St Angel INV-47242, 3β8 Jul 2025 | Allergy / inflammation |
| Mucolytic injection | Γ1.5 | St Angel INV-47242, 3β8 Jul 2025 | Respiratory support (nebulisation) |
| Probiotics | Γ3 | St Angel INV-47242, 3β8 Jul 2025 | GI support |
| Hill's S/D c/d (prescription food) | Γ1 can | St Angel INV-47242, 3β8 Jul 2025 | Urinary prescription diet |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Tramadol injection / Acugesic | 7.2ml Γ RM2.50/ml | UPM BILL-2303, 8β18 Jul 2025 | Analgesia |
| Furosemide (Rasitol) injection | 2.4ml | UPM BILL-2303, 8β18 Jul 2025 | Diuretic (fluid management) |
| Marbocyl 2% injection | 6ml | UPM BILL-2303, 8β18 Jul 2025 | Empirical antibacterial |
| Cystaid Cat capsule | Γ10 | UPM BILL-2303, 8β18 Jul 2025 | Bladder GAG support |
| Augmentin 457mg/5ml suspension | 1 bottle | UPM BILL-2303, 8β18 Jul 2025 | Antibacterial |
| Bromhexine injection | 4.75ml Γ RM2.60 | UPM BILL-2303, 8β18 Jul 2025 | Mucolytic / respiratory support |
| Acetylcysteine 200mg powder + empty capsules | β | UPM BILL-2303, 8β18 Jul 2025 | Mucolytic / antioxidant |
| Dentisept 20g tube | Γ1 | UPM BILL-2303, 8β18 Jul 2025 | Oral hygiene / gingivitis |
| Sodium Chloride 0.9% (NaCl) IV fluids | β | UPM BILL-2303, 8β18 Jul 2025 | IV fluid therapy |
| Sodium Lactate IV | 3 Γ 500ml | UPM BILL-2303, 8β18 Jul 2025 | IV fluid therapy (electrolyte) |
| Gentamicin 10% injection | 10.5ml | UPM BILL-2303, 8β18 Jul 2025 | Antibacterial (topical/wound) |
| Tobramycin eye drops (Tobrex) | Γ1 | UPM BILL-2303, 8β18 Jul 2025 | Eye infection |
| Tears Naturale eye drops | Γ1 | UPM BILL-2303, 8β18 Jul 2025 | Dry eye / KCS lubrication |
| Nicol (Chloramphenicol) eye drops | Γ1 | UPM BILL-2303, 8β18 Jul 2025 | Eye infection |
| Vaseline 30g / Calamine cream / Gentamicin cream | β | UPM BILL-2303, 8β18 Jul 2025 | Wound / skin care |
| Catosal 10% injection (B12 complex) | β | UPM BILL-2303, 8β18 Jul 2025 | Metabolic support |
| Papain/Beazyme tablets | Γ20 | UPM BILL-2303, 8β18 Jul 2025 | Enzyme / anti-inflammatory |
| Bromhexine 8mg tab | Γ2 | UPM BILL-2303, 8β18 Jul 2025 | Mucolytic |
| RC Canine & Feline Recovery | β | UPM BILL-2303, 8β18 Jul 2025 | Nutritional recovery (NG tube) |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Azodyl capsule | Γ104 (ward); Γ8 (Aug); Γ10 (Jul) | INV-2883, INV-2987, INV-2937 | CKD / uremic toxin |
| Dantrolene Sodium 25mg cap | Γ36 (ward ~30 Jul); Γ8 (Aug) | INV-2883, INV-2987 | Smooth muscle relaxant (bladder/urethral) |
| Papain / Beazyme 150000 IU | Γ38; Γ8 | INV-2883, INV-2987 | Enzyme / anti-inflammatory |
| Famvir (Famciclovir 500mg) | Γ60 | INV-2883 (~30 Jul period) | FHV-1 antiviral |
| Cetirizine 10mg tablet | Γ7 | INV-2883 | Antihistamine |
| Tolfedine injection | Γ1 | INV-2883 | NSAID anti-inflammatory |
| Tramadol injection | Γ7 | INV-2937 (Jul ward) | Analgesia |
| Stemtech AFA Extract | Γ6 | INV-2937 (Jul ward) | Stem cell / immune support supplement |
| Mirtazapine 15mg/ml cream (original tube) | Γ1 tube + 1.6ml dispensed | INV-2987 (~Aug) | Appetite stimulant |
| Wecysto Plus Gel | 16ml | INV-2987 (~Aug) | Bladder GAG support |
| Darbepoetin (DPO) injection | 0.2ml (Γ1 dose) | INV-2987 (~7 Aug) | Erythropoiesis stimulator |
| Maropitant (transdermal) | β | Jawharicat invoice, 23 Aug 2025 | Anti-nausea |
| Hill's K/D feline mince chicken | Γ21 cans | INV-2987 | Renal prescription diet |
| Hill's K/D feline dry 1.8kg | Γ1 bag | INV-2987 | Renal prescription diet |
| Calmurofel capsule | Γ30 | INV-2987 | Bladder mucosal support |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Refresh Tears eye drops | Γ1 (BID both eyes) | AMC invoice 3115662, 29 Aug 2025 | KCS lubrication |
| Ridinox 0.1% (Idoxuridine) eye drops | Γ1 (BID both eyes) | AMC invoice 3115662, 29 Aug 2025 | Herpes corneal ulcer |
| Topizole Medicated Shampoo 250ml | Γ1 (1Γ/week) | AMC invoice 3115662, 29 Aug 2025 | Fungal skin disease |
| Urajiron tablet | Γ1 (RM 390) | AMC invoice 3133299 / Sep 2025 | Iron supplementation (anaemia) |
| Entero-Chronic 4g sachet | Γ7 sachets (RM 59.50) | AMC invoice 3133299, Oct 2025 | GI support / chronic enteropathy |
| Gabapentin 300mg tab | Γ1 (pre-procedure) | AMC invoice 3133680, 2 Oct 2025 | Pre-anaesthesia sedation / pain |
| Fentanyl 0.05mg/ml injection | Γ2 (RM 32.60) | AMC invoice 3133678, 2 Oct 2025 | Anaesthetic analgesia (cystotomy/endoscopy) |
| Ampicillin Sodium 500mg injection | 1.3ml (RM 29.30) | AMC invoice 3133687, 2 Oct 2025 | Intraoperative antibacterial prophylaxis |
| Ranitidine 25mg/ml injection | 0.45ml (RM 27.60) | AMC invoice 3133687, 2 Oct 2025 | Gastric acid / GI protection (peri-operative) |
| Robenacoxib (Onsior) 20mg/ml injection | 0.60ml (RM 44.80) | AMC invoice 3133687, 2 Oct 2025 | Post-operative NSAID analgesia |
| Tramadol 50mg/ml injection | 0.50ml (RM 32.00) | AMC invoice 3133687, 2 Oct 2025 | Post-operative analgesia |
| Calmurofel capsule | Γ30 (discharge) | AMC invoice 3133732, 2 Oct 2025 | Bladder mucosal support (post-cystotomy) |
| Dantrolene 25mg capsule | Γ5 (discharge) | AMC invoice 3133732, 2 Oct 2025 | Smooth muscle relaxant |
| Famotidine 20mg tab | Γ2 (discharge) | AMC invoice 3133732, 2 Oct 2025 | Gastric acid reduction |
| Gabapentin 100mg tab | Γ5 (discharge) | AMC invoice 3133732, 2 Oct 2025 | Pain management |
| Onsior (Robenacoxib) 6mg cat tab | Γ3 | AMC invoice 3133732, 2 Oct 2025 | Post-operative NSAID (oral, 3 days) |
| Clavaseptin 250mg tab | Γ1 | AMC invoice 3133709, 2 Oct 2025 | Antibacterial |
| Gabapentin 150mg (compounded) | β | AMC invoice, 3 Sep 2025 | Pain management |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Gabapentin 100mg | β | Shinzovet, 16 Sep 2025 | Pain management / pre-anaesthesia |
| Augmentin (Amoxicillin-clav) | 15mg/kg BID Γ14 days | Shinzovet Cardiology Report, 30 Sep 2025 | E. coli UTI (culture confirmed susceptible) |
| Drug | Qty / Dose | Source | Indication |
|---|---|---|---|
| Darbepoetin 20mcg/0.5ml injection | Γ1 syringe | KD Vet invoice K2436660, 20 Sep 2025 | Erythropoiesis stimulator (anaemia) |
| Methycobal injection | <1 ampoule | KD Vet invoice K2436660, 20 Sep 2025 | Vitamin B12 / nerve support |
| Drug | Source | Indication |
|---|---|---|
| Virbagen Omega (Feline Interferon-Ο) β Cycles 1, 2, 3 | Owner-sourced separately (not dispensed by any clinic) | FHV-1 / Calicivirus (PCR confirmed) |
| Imipenem IV | Owner-sourced (multiple purchases); IV administered by clinics | MDR Pseudomonas + Enterobacter (confirmed Susceptible) |
| Ceftazidime IM | Owner-sourced (RM 272.15, Dec 2025); IM administered by Nuro Vet + Petsville | MDR gram-negative recurrence |
| Drug | Period | Route | Indication | Source |
|---|---|---|---|---|
| Clavaseptin (Amoxicillin-clav 62mg) | JunβJul 2025 | Oral | Initial UTI empirical | Petsville / Jawharicat |
| Imipenem | JulβAug 2025 | IV | MDR Pseudomonas + Enterobacter β confirmed Susceptible | UPM, Jawharicat (administered); owner-sourced |
| Augmentin (Amoxicillin-clav) | SepβOct 2025 | Oral | E. coli UTI (cystocentesis culture β Susceptible) | Petsville / AMC |
| Ceftazidime IM | Dec 2025 | IM injection | Recurrent MDR gram-negative (Pseudomonas-spectrum) | Nuro Vet + Petsville (administered); owner-sourced |
| Marbofloxacin | Jul 2025 (single dose) | SQ | Empirical (Pseudomonas R β discontinued) | Petsville |
| Clinician | Facility | Specialty | Period |
|---|---|---|---|
| Dr Aishah | Petsville | General Practice | JunβJul 2025 |
| Dr Salina | St Angel Veterinary | General Practice / Emergency | Jul 2025 |
| Dr Darren | UPM Veterinary Hospital | Internal Medicine / ICU | Jul 2025 |
| Dr Muhammad Khayeer Al-Farouq | Jawharicat Veterinary Centre (68000 Ampang) | General / Internal Medicine / ICU | Jun 2025 β ongoing |
| Dr Amilan Sivagurunathan BVSc(Hons), Cert Ophth, MmedVet(Ophth) | AMC (Animal Medical Centre, HQ KL) | Consultant Ophthalmologist | Aug 2025 β ongoing |
| Dr Nadzariah Cheng | Consulted Barkoba's eyes (16 Jul 2025) β billed via Animed | Ophthalmologist | 16 Jul 2025 |
| Dr Sivan | AMC | Cardiology | Oct 2025 |
| Dr Elise Robertson | AMC (Visiting Specialist) | Internal Medicine / Surgery (Cystotomy, Endoscopy) | Oct 2025 |
| Dr Anthony Leong (Vetcardio Services) | Shinzovet (Kota Damansara) | Cardiologist β Echocardiography | SepβOct 2025 |
| Dr Stephanie Lavania Petrus | AMC | General / Internal Medicine | Oct 2025 |
| Dr Ruth Lau | Housecall | General Practice | Aug 2025 |
| Dr Petunia | Housecall | General Practice | Aug 2025 |
| Tom Vicek DVM PhD DipACVP MRCVS | FINN Pathologists (UK) | Anatomic Pathology + Microbiology | Oct 2025 |
| Rachel Millar BVMS, Cert. SAM, MRCVS | FINN Pathologists (UK) | Internal Medicine (Antimicrobial comment) | Oct 2025 |
| Date | Activity | Estimated Cost | Remarks / Rules |
|---|---|---|---|
| 2 May 2026 | Full blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC, urine culture | RM 655 + UPC | Baseline before Injection 1 |
| 9 May 2026 | Stem cell product cycle 1 + Injection 1 | RM 1,370 + injection fee | Covers Injections 1 and 2 |
| 23 May 2026 | Reduced blood: CBC, renal, SDMA, electrolytes, urinalysis, urine USG | RM 505 + urinalysis | Pre-Injection 2 checkpoint β review result same day |
| 24 May 2026 | Injection 2 | Injection fee separate | Proceed only if clinically stable |
| 6 June 2026 | Stem cell product cycle 2 + Injection 3 | RM 1,370 + injection fee | Covers Injections 3 and 4 |
| 19 June 2026 | Full blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC, urine culture | RM 655 + UPC | β Monthly microbiology checkpoint β major decision point |
| 20 June 2026 | Injection 4 | Injection fee separate | Continue only if measurable benefit confirmed |
| 4 July 2026 | Stem cell product cycle 3 + Injection 5 | RM 1,370 + injection fee | Covers Injections 5 and 6 |
| 17 July 2026 | Reduced blood: CBC, Chem17, Lytes, SDMA, urinalysis, urine USG, UPC | RM 505 + UPC + urinalysis | Final pre-Injection 6 review |
| 18 July 2026 | Injection 6 | Injection fee separate | Final biologic phase |
| Monthly (after first no-growth) | Urine culture only | RM 150 each | Continue until 3 consecutive no-growth results β exit criterion |
| Flexible | AMC review β Dr Stephanie Lavania Petrus | AMC fee | Anytime she deems clinically necessary |
Source: "Barkoba_Version_4_0_Final_Master_Schedule.docx" β Google Drive, uploaded 27 April 2026. Treatment commencement: 2 May 2026.
| Category | Total Spent |
|---|---|
| Vet bills (all clinics) | RM 64,647.25 |
| Prescription diet | RM 7,736.07 |
| Supplements | RM 3,504.85 |
| Interferon Omega (Virbagen β viral) | RM 9,500.00 |
| Antibiotics β Bacteria (Imipenem, Ceftazidime etc.) | RM 3,055.40 |
| External diagnostics | RM 1,210.00 |
| MISC (logistics, homecare, consumables) | RM 2,925.78 |
| Funding received (crowdfunding/community) | RM 8,665.70 |
| TOTAL PAID | RM 92,856.54 |
| Owner-funded portion | RM 84,190.84 |
Source: "Barkoba Finance" Google Sheets tracker β data through 24 April 2026. Figures exclude planned MayβJuly 2026 stem cell protocol (estimated additional RM 4,110β5,500+ for 3 cycles + injections).