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{'patient': {'bday': '2024-03-10', 'name': 'Mitchell^Shiloh', 'breed': 'Shepherd Mix', 'owner': 'Mitchell^Kamila', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'UNALTERED', 'species_other': ''}, 'hospital': {'name': 'Burrard Animal Hospital + Emergency', 'email': '[email protected]', 'address': 'Canada - Vancouver', 'clinician': 'Brianca Wong'}, 'accept_tos': 'true', 'consult_info': {'case_info': '6 days ago started having D+ then loose stools, not urgent-went on for a few days then had normal stools 2 days ago\r\nlast night V+ food and bile, was not eating lunch and dinner, drinking water okay\r\n1 hr ago V+ with blood and fresh blood\r\ngums seemed pale\r\nhas been wanting to stay outside, whining to go out but not trying to urinate or defecate\r\nhad Salmon on Saturday-new in diet\r\n', 'questions': 'Rule out foreign body, cause of blood in vomit', 'specialty_area': ''}}

{'tags': {'userTags': ['standard_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'text', 'consults_sorting': 'manual', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1005, 'state': 'empty', 'source': 'rules'}, {'id': 1025, 'state': 'ready', 'source': 'rules'}, {'id': 1026, 'state': 'abnormal', 'source': 'rules'}, {'id': 1027, 'state': 'partial', 'source': 'rules'}, {'id': 1053, 'state': 'inprogress', 'source': 'rules'}, {'id': 1095, 'state': 'inprogress', 'source': 'rules'}], 'consult': [{'id': 245, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 1, 'elapsedTime': 86.262, 'consult_name': 'Intestines - Gastroenteritis, foreign material', 'isAddressingConcern': True, 'diagnosis_custom_text': 'There is material noted in the GI tract therefore dietary indiscretion should be a primary consideration. No obstructive pattern is noted. Gastroenteritis, pancreatitis, or a systemic illness causing secondary GI signs can not be ruled out completely. Upper GI pathology, coagulation, or ulceration is not excluded.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Medical management of the reported clinical signs is indicated at this time. If there is no response to medical management, consider repeat radiographs and/or abdominal ultrasound to further investigate the identified intestinal foreign material. Lab testing for pancreatitis could also be considered. Endoscopy to evaluate the esophagus, stomach, and duodenum and a coagulation panel could be considered if clinically indicated.', 'recommendation_custom_fields': None}], 'signals': [{'id': 76, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Diarrhea-c'}, {'id': 256, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Vomiting'}, {'id': 282, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Vomiting with blood'}, {'id': 2656, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'medium-large-breed'}], 'findings': [{'id': 11, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bladder-bladder-stone', 'custom_fields': None, 'finding_normal_text': 'The urinary bladder is within normal limits. ', 'finding_abnormal_text': 'There is ___s1_ opacity noted over the silhouette of the urinary bladder. '}, {'id': 17, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-limb-fracture', 'custom_fields': None, 'finding_normal_text': 'No appendicular fractures are noted. ', 'finding_abnormal_text': 'There is a ___s1_ fracture of the ___s2_. '}, {'id': 723, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None, 'finding_normal_text': 'No aggressive osseous lesions identified. ', 'finding_abnormal_text': 'There is a bone lesion with evidence of ___s1_ identified in ___s2_. '}, {'id': 733, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'esophagus-foreign-body', 'custom_fields': None, 'finding_normal_text': '.', 'finding_abnormal_text': 'A ___s1_ opacity foreign body is present in the ___s2_ esophagus.'}, {'id': 738, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'intestines-small-fm-foreign-material', 'custom_fields': {'___s1_': ['radio-opaque']}, 'finding_normal_text': 'Small Intestinal Foreign Material', 'finding_abnormal_text': 'There is ___s1_ foreign material located within the small intestine.'}, {'id': 787, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'tracheal-narrowing', 'custom_fields': None, 'finding_normal_text': 'The trachea is unremarkable with normal diameter. ', 'finding_abnormal_text': 'There is ___s1_ narrowing of the trachea ___s2_ . '}, {'id': 1932, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-mass-effect', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of a mass or mass effect within the abdomen. ', 'finding_abnormal_text': 'In the ___s1_ abdomen, there is displacement of ___s2_.'}, {'id': 1933, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-limited-detail', 'custom_fields': None, 'finding_normal_text': 'The serosal detail of the abdomen is normal. ', 'finding_abnormal_text': 'There is ___s1_ loss of serosal detail in the abdomen. '}, {'id': 2141, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-thoracic-mass', 'custom_fields': None, 'finding_normal_text': 'No pulmonary masses, lymphadenopathy, or mediastinal masses are noted. ', 'finding_abnormal_text': 'There ___s1_ noted in the ___s2_ thorax, ___s3_ '}, {'id': 2160, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-diaphragmatic-hernia', 'custom_fields': None, 'finding_normal_text': 'The diaphragm is unremarkable. ', 'finding_abnormal_text': 'There is evidence of herniation of abdominal organs into the thoracic cavity. The ___s1_ appears herniated into the ___s2_. '}, {'id': 2230, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-subluxation', 'custom_fields': None, 'finding_normal_text': 'There is adequate acetabular coverage of the femoral heads with no subluxation noted. ', 'finding_abnormal_text': 'There is evidence of hip incongruity of the ___s1_ hip. '}, {'id': 2231, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-neck-thicking', 'custom_fields': None, 'finding_normal_text': 'There are no degenerative changes noted in the coxofemoral joints. ', 'finding_abnormal_text': 'There are degenerative changes affecting the ___s1_ coxofemoral joint. '}, {'id': 2275, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'soft-tissue-swelling', 'custom_fields': None, 'finding_normal_text': 'There is no soft tissue swelling. ', 'finding_abnormal_text': 'There is soft tissue swelling involving ___s1_. '}, {'id': 2278, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-fields', 'custom_fields': None, 'finding_normal_text': 'Lung fields are clear. ', 'finding_abnormal_text': 'cvp-cdp-bpp-tms'}, {'id': 2284, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'pleural-space', 'custom_fields': None, 'finding_normal_text': 'The pleural space is normal. ', 'finding_abnormal_text': 'There is evidence of pleural fluid and gas. '}, {'id': 2285, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'stomach-distension-find', 'custom_fields': None, 'finding_normal_text': 'The stomach appears empty. ', 'finding_abnormal_text': 'There is ___s1_ distension of the stomach with the presence of radiopaque material which has the appearance of ___s2_ . '}, {'id': 2295, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'kidney-margins', 'custom_fields': None, 'finding_normal_text': 'The visualized kidneys are within normal limits. ', 'finding_abnormal_text': 'rmn, rmg, skd'}, {'id': 2296, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'urolithiasis', 'custom_fields': None, 'finding_normal_text': 'No evidence of urolithiasis. ', 'finding_abnormal_text': 'urolithiasis'}, {'id': 2299, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of degenerative joint disease. ', 'finding_abnormal_text': 'There is evidence of degenerative joint disease. '}, {'id': 2300, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'coxofemoral-pelvis', 'custom_fields': None, 'finding_normal_text': 'The coxofemoral joints and pelvis are unremarkable. ', 'finding_abnormal_text': 'hoa, hlx, pfx, not hic'}, {'id': 2488, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': 'There is mild, diffuse distension of the colon with poorly formed stool. ', 'elapsedTime': 6.539, 'signal_name': 'normal-colon', 'custom_fields': {'___s1_': ['mild', 'diffuse']}, 'finding_normal_text': 'The colon is unremarkable.', 'finding_abnormal_text': 'There is ___s1_ distension of the colon with stool. '}, {'id': 2500, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fluid-wispy', 'custom_fields': None, 'finding_normal_text': 'Normal Wispy Fluid', 'finding_abnormal_text': 'There is a wispy soft tissue opacity noted over the ___s1_ in the ___s2_ abdomen.'}], 'diagnosis': [], 'questions': [{'id': 2661, 'source': 'labelling', 'attention': False, 'signal_name': 'Gi signs - Systemic vs general'}], 'recommendations': [{'id': 1379, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'recommendation_name': 'dietary-change'}], 'report_findings': 'Thorax\nThe observed thorax is within normal limits. No abnormal thoracic findings are noted.\n\nAbdomen\nThere is radiopaque foreign material located within the small intestine. There is mild, diffuse distension of the colon with poorly formed stool. The rest of the observed abdomen is within normal limits.\n\nMusculoskeletal\nThe observed musculoskeletal system is within normal limits. No abnormal musculoskeletal findings are noted.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': True}, {'id': 7, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pneumothorax', 'is_locked_out': True}, {'id': 9, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': False}, {'id': 10, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': True}, {'id': 12, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-distention', 'is_locked_out': True}, {'id': 13, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': True}, {'id': 14, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': True}, {'id': 15, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': True}, {'id': 16, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': True}, {'id': 17, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': False}, {'id': 699, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'kidney-mineralization', 'is_locked_out': True}, {'id': 700, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': False}, {'id': 702, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': False}, {'id': 703, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-mass', 'is_locked_out': False}, {'id': 708, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'urethra-calculi', 'is_locked_out': True}, {'id': 712, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': True}, {'id': 713, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': True}, {'id': 715, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': True}, {'id': 723, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': True}, {'id': 738, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': True}, {'id': 740, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'colon-foreign-material', 'is_locked_out': False}, {'id': 744, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'fecal-impaction', 'is_locked_out': False}, {'id': 762, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-osteophytosis', 'is_locked_out': False}, {'id': 783, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'right-heart-enlargement', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'tracheal-narrowing', 'is_locked_out': True}, {'id': 790, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-luxation', 'is_locked_out': True}, {'id': 797, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-renomegaly', 'is_locked_out': False}, {'id': 798, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-small', 'is_locked_out': False}, {'id': 799, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-distension', 'is_locked_out': True}, {'id': 870, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-gas', 'is_locked_out': True}, {'id': 879, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-gas', 'is_locked_out': True}, {'id': 880, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'general-cardiomegaly', 'is_locked_out': False}, {'id': 947, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-vhs', 'is_locked_out': False}, {'id': 1605, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': True}, {'id': 1635, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': True}, {'id': 1933, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': True}, {'id': 2141, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': True}, {'id': 2158, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': False}, {'id': 2160, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': True}, {'id': 2166, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': False}, {'id': 2215, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'body-score', 'is_locked_out': False}, {'id': 2230, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-subluxation', 'is_locked_out': True}, {'id': 2231, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-neck-thicking', 'is_locked_out': True}, {'id': 2252, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'patellar-luxation', 'is_locked_out': False}, {'id': 2259, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2260, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fluid-distension-SI', 'is_locked_out': False}, {'id': 2275, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': True}, {'id': 2368, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'liver-mass', 'is_locked_out': False}, {'id': 2401, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'pylorus-displacement', 'is_locked_out': False}, {'id': 2410, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'summation-structures', 'is_locked_out': False}, {'id': 2436, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'ileus-diffuse-distension-SI', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2454, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'SI-bunching', 'is_locked_out': False}, {'id': 2487, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'colon-distension', 'is_locked_out': False}, {'id': 2500, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fluid-wispy', 'is_locked_out': False}, {'id': 2560, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'splenic-nodule', 'is_locked_out': False}, {'id': 2562, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'splenic-mass', 'is_locked_out': False}, {'id': 2568, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Gastric wall thickening', 'is_locked_out': False}, {'id': 2606, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Chronic Fecal Material', 'is_locked_out': False}, {'id': 2641, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spondylosis-dish', 'is_locked_out': True}, {'id': 2642, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spondylosis-bridging', 'is_locked_out': True}, {'id': 2669, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Mild small intestinal distention', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nThere is material noted in the GI tract; therefore, dietary indiscretion should be a primary consideration. No obstructive pattern is noted. Gastroenteritis, pancreatitis, or a systemic illness causing secondary GI signs can not be ruled out completely. Upper GI pathology, coagulation, or ulceration is not excluded.\n\nRecommendations:\nMedical management of the reported clinical signs is indicated at this time. If medical management does not result in a response, consider repeat radiographs and/or abdominal ultrasound to further investigate the identified intestinal foreign material. Lab testing for pancreatitis could also be considered. If clinically indicated, endoscopy to evaluate the esophagus, stomach, and duodenum and a coagulation panel could also be considered.'}

{'bday': '2024-03-10', 'name': 'Mitchell^Shiloh', 'breed': 'Shepherd Mix', 'owner': 'Mitchell^Kamila', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'UNALTERED', 'species_other': ''}

{'name': 'Burrard Animal Hospital + Emergency', 'email': '[email protected]', 'address': 'Canada - Vancouver', 'clinician': 'Brianca Wong'}

6 days ago started having D+ then loose stools, not urgent-went on for a few days then had normal stools 2 days ago last night V+ food and bile, was not eating lunch and dinner, drinking water okay 1 hr ago V+ with blood and fresh blood gums seemed pale has been wanting to stay outside, whining to go out but not trying to urinate or defecate had Salmon on Saturday-new in diet

Rule out foreign body, cause of blood in vomit

standard

['Gi signs - Systemic vs general']

['Diarrhea', 'Vomiting', 'Hematemesis (vomiting blood)', 'Canine Medium/Large Breed']

[]

[76, 256, 282, 2656]

[]

[]

[]

[]

[]

['Dietary change']

[]

[1379]

[]

{'patient': {'bday': '2014-09-05', 'name': 'Pinto', 'breed': 'MIXED', 'owner': 'Osollo', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}, 'hospital': {'name': 'Animal Emergency Clinic of Pasadena', 'email': '[email protected]', 'address': 'United States - Pasadena', 'clinician': 'Kristie Villicana'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'History of inappetance x 1 week. VOmiting today, no diarrhea. Icteric pinnae, tense on abdominal palpation.\r\nCBC: WBC +59.84 ( 6-17), LYM +6.73 (1-4.8), MON +5.56 (0.2-1.5), NEU +47.35(3-12), RBC -3.66 (5.5-8.5), HGB -7.9 (12-18), HCT -25.02 (37-55), RDWc +22.6 (14-20), MPV +11.6 (3.9-11.1)\r\nCHEM: ALB -1.6 (2.5-4.4), ALP +1070 ( 20-150), ALT +633 (10-118), AMY +2822 ( 200-1200), TBIL +23.1 (0.1-0.6), GLOB -0.0 (2.3-5.2) \r\n\r\nCpli: Abnormal \r\n\r\n', 'questions': 'r/o post-hepatic icterus, pancreatitis/biliary obstruction', 'specialty_area': ''}}

{'tags': {'userTags': ['expert_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'text', 'consults_sorting': 'manual', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1005, 'state': 'empty', 'source': 'rules'}, {'id': 1022, 'state': 'abnormal', 'source': 'rules'}, {'id': 1025, 'state': 'abnormal', 'source': 'rules'}, {'id': 1026, 'state': 'abnormal', 'source': 'rules'}, {'id': 1036, 'state': 'abnormal', 'source': 'rules'}, {'id': 1053, 'state': 'excluded', 'source': 'rules'}, {'id': 1095, 'state': 'abnormal', 'source': 'rules'}], 'consult': [{'id': 291, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 4, 'elapsedTime': 2.834, 'consult_name': 'Cardiac - Hypovolemia, microcardia', 'isAddressingConcern': False, 'diagnosis_custom_text': 'A small vena cava likely indicates hypovolemia. ', 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1103, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 2, 'elapsedTime': 69.841, 'consult_name': 'Intestines - Pancreatitis, normal GIT, pancreatitis test pos', 'isAddressingConcern': True, 'diagnosis_custom_text': 'Given the normal appearance of the GI tract, the focal loss of detail in the right cranial abdomen, and the clinical history provided, clinical signs may be consistent with concurrent pancreatitis. No evidence of intestinal foreign body or intestinal obstruction is noted. Other differentials include gastroenteritis due to inflammatory, dietary indiscretion, toxin, infectious, or parasitic causes. ', 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Confirm pancreatitis with abdominal ultrasound. Recommend supportive medical management for pancreatitis and close monitoring of patient.', 'recommendation_custom_fields': None}, {'id': 1251, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 5, 'consult_name': 'Spine general - Bridging spondylosis, no pain', 'isAddressingConcern': False, 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1344, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 3, 'consult_name': 'Gastric - Food vs foreign, no GAD, asymptomatic(not clear kibble)', 'isAddressingConcern': False, 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1372, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': 1, 'elapsedTime': 13.56, 'consult_name': 'Hepatomegaly - HMG + gall bladder mineralization', 'isAddressingConcern': True, 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Abdominal ultrasound for further investigation of the hepatomegaly and mineralization is recommended. A FNA sampling , or more likely a biopsy, may also be necessary for a definitive diagnosis.', 'recommendation_custom_fields': None}], 'signals': [{'id': 113, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Icterus'}, {'id': 256, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Vomiting'}, {'id': 607, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'hyporexia'}, {'id': 622, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Pain - abdominal'}, {'id': 2404, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'liver-enzymes-elevated'}, {'id': 2542, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'pancreatic-lipase'}, {'id': 2634, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Neutrophilia'}, {'id': 2656, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'medium-large-breed'}], 'findings': [{'id': 9, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'spondylosis-spondylosis', 'custom_fields': {'___s1_': ['lumbar']}, 'finding_normal_text': 'Spondylosis', 'finding_abnormal_text': 'There is spondylosis deformans noted in the ___s1_ spine. '}, {'id': 17, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-limb-fracture', 'custom_fields': None, 'finding_normal_text': 'No appendicular fractures are noted. ', 'finding_abnormal_text': 'There is a ___s1_ fracture of the ___s2_. '}, {'id': 20, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': 'The liver appears to have very rounded edges. ', 'elapsedTime': 15.643999999999998, 'signal_name': 'liver-hepatomegaly', 'custom_fields': None, 'finding_normal_text': 'The liver is unremarkable. ', 'finding_abnormal_text': 'The liver appears enlarged. '}, {'id': 702, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'spleen-splenomegaly', 'custom_fields': None, 'finding_normal_text': 'The spleen appears normal in size and contour. ', 'finding_abnormal_text': 'The spleen appears ___s1_ enlarged ___s2_ '}, {'id': 723, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None, 'finding_normal_text': 'No aggressive osseous lesions identified. ', 'finding_abnormal_text': 'There is a bone lesion with evidence of ___s1_ identified in ___s2_. '}, {'id': 733, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'esophagus-foreign-body', 'custom_fields': None, 'finding_normal_text': '.', 'finding_abnormal_text': 'A ___s1_ opacity foreign body is present in the ___s2_ esophagus.'}, {'id': 787, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'tracheal-narrowing', 'custom_fields': None, 'finding_normal_text': 'The trachea is unremarkable with normal diameter. ', 'finding_abnormal_text': 'There is ___s1_ narrowing of the trachea ___s2_ . '}, {'id': 880, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'general-cardiomegaly', 'custom_fields': None, 'finding_normal_text': 'The cardiac silhouette is normal in size and shape. ', 'finding_abnormal_text': 'There appears to be a generalized enlargement of the heart ___s1_'}, {'id': 947, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'heart-vhs', 'custom_fields': None, 'finding_normal_text': 'The cardiac silhouette is normal in size and shape. ', 'finding_abnormal_text': 'The heart measures above the normal range ___s1_'}, {'id': 1605, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'stomach-n-gastric-material', 'custom_fields': {'___s1_': ['kibble/food']}, 'finding_normal_text': 'The stomach is empty.', 'finding_abnormal_text': 'There is radiopaque material within the stomach which has the appearance of ___s1_. '}, {'id': 1932, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-mass-effect', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of a mass or mass effect within the abdomen. ', 'finding_abnormal_text': 'In the ___s1_ abdomen, there is displacement of ___s2_.'}, {'id': 2141, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-thoracic-mass', 'custom_fields': None, 'finding_normal_text': 'No pulmonary masses, lymphadenopathy, or mediastinal masses are noted. ', 'finding_abnormal_text': 'There ___s1_ noted in the ___s2_ thorax, ___s3_ '}, {'id': 2159, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-rib-fracture', 'custom_fields': None, 'finding_normal_text': 'No evidence of rib fracture is observed.', 'finding_abnormal_text': 'There is ___s1_ fracture of the ___s2_ rib. '}, {'id': 2160, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-diaphragmatic-hernia', 'custom_fields': None, 'finding_normal_text': 'The diaphragm is unremarkable. ', 'finding_abnormal_text': 'There is evidence of herniation of abdominal organs into the thoracic cavity. The ___s1_ appears herniated into the ___s2_. '}, {'id': 2166, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'heart-left-atrial-enlarge', 'custom_fields': None, 'finding_normal_text': 'No left atrial enlargement is present.', 'finding_abnormal_text': 'There is evidence of left atrial enlargement.'}, {'id': 2263, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'liver-mineralization', 'custom_fields': {'___s1_': ['the gallbladder']}, 'finding_normal_text': 'Liver Mineralization', 'finding_abnormal_text': 'A mineral opacity is noted over the liver in the region of ___s1_. '}, {'id': 2278, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-fields', 'custom_fields': None, 'finding_normal_text': 'Lung fields are clear. ', 'finding_abnormal_text': 'cvp-cdp-bpp-tms'}, {'id': 2284, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'pleural-space', 'custom_fields': None, 'finding_normal_text': 'The pleural space is normal. ', 'finding_abnormal_text': 'There is evidence of pleural fluid and gas. '}, {'id': 2295, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'kidney-margins', 'custom_fields': None, 'finding_normal_text': 'The visualized kidneys are within normal limits. ', 'finding_abnormal_text': 'rmn, rmg, skd'}, {'id': 2298, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'intervertebral-disc-space', 'custom_fields': None, 'finding_normal_text': 'No significant intervertebral disc space narrowing is identified. ', 'finding_abnormal_text': 'There is intervertebral disc space narrowing at ___s1_. '}, {'id': 2299, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of degenerative joint disease. ', 'finding_abnormal_text': 'There is evidence of degenerative joint disease. '}, {'id': 2414, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'caudal-vena-cana-sm', 'custom_fields': None, 'finding_normal_text': 'caudal vena cava small', 'finding_abnormal_text': 'The caudal vena cava appears to be narrowed. '}, {'id': 2500, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fluid-wispy', 'custom_fields': None, 'finding_normal_text': 'Normal Wispy Fluid', 'finding_abnormal_text': 'There is a wispy soft tissue opacity noted over the ___s1_ in the ___s2_ abdomen.'}, {'id': 2501, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': 'The loss of detail is focal, associated with the liver observed in the right cranial abdomen on the VD. ', 'elapsedTime': 9.559, 'signal_name': 'focal-loss-detail', 'custom_fields': {'___s1_': ['liver'], '___s2_': ['cranial']}, 'finding_normal_text': 'N/A', 'finding_abnormal_text': 'The loss of detail is focal, associated with the ___s1_ observed in the ___s2_ abdomen.'}], 'diagnosis': [{'id': 659, 'state': 'abnormal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 100, 'diagnosis_name': 'Anaemia'}], 'questions': [{'id': 2661, 'source': 'labelling', 'attention': False, 'signal_name': 'Gi signs - Systemic vs general'}], 'recommendations': [], 'report_findings': 'The radiographic examination of the abdomen reveals that the liver has rounded edges. There is radiopaque material present within the stomach, resembling kibble or food. Additionally, a mineral opacity is observed over the liver in the region typically associated with the gallbladder. This opacity is causing a focal loss of detail, particularly noted in the right cranial abdomen on the ventrodorsal view. No other abnormalities are detected in the rest of the abdomen.\n\nSpondylosis deformans are noted in the lumbar spine. No other abnormalities are observed in the musculoskeletal system.\n\nRegarding the thorax, the caudal vena cava appears to be narrowed. No additional abnormalities were noted in the thoracic region.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': True}, {'id': 7, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pneumothorax', 'is_locked_out': True}, {'id': 9, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': True}, {'id': 10, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': False}, {'id': 12, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-distention', 'is_locked_out': True}, {'id': 13, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': True}, {'id': 14, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': True}, {'id': 15, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': True}, {'id': 16, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': True}, {'id': 17, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': True}, {'id': 699, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'kidney-mineralization', 'is_locked_out': True}, {'id': 700, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': True}, {'id': 702, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': True}, {'id': 703, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-mass', 'is_locked_out': False}, {'id': 708, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': True}, {'id': 713, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': True}, {'id': 715, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': True}, {'id': 723, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': True}, {'id': 738, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': True}, {'id': 762, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-osteophytosis', 'is_locked_out': False}, {'id': 783, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'right-heart-enlargement', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'tracheal-narrowing', 'is_locked_out': True}, {'id': 790, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-luxation', 'is_locked_out': True}, {'id': 797, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-renomegaly', 'is_locked_out': False}, {'id': 798, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-small', 'is_locked_out': False}, {'id': 799, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-distension', 'is_locked_out': True}, {'id': 870, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-gas', 'is_locked_out': True}, {'id': 879, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-gas', 'is_locked_out': True}, {'id': 880, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'general-cardiomegaly', 'is_locked_out': True}, {'id': 947, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'heart-vhs', 'is_locked_out': True}, {'id': 1605, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': True}, {'id': 1635, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': True}, {'id': 1933, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': True}, {'id': 2141, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': True}, {'id': 2158, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': True}, {'id': 2160, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': True}, {'id': 2166, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': True}, {'id': 2215, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'body-score', 'is_locked_out': True}, {'id': 2217, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'potential-contrast-study', 'is_locked_out': False}, {'id': 2230, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-subluxation', 'is_locked_out': False}, {'id': 2231, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-neck-thicking', 'is_locked_out': False}, {'id': 2252, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'patellar-luxation', 'is_locked_out': False}, {'id': 2259, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': True}, {'id': 2260, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fluid-distension-SI', 'is_locked_out': False}, {'id': 2263, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'liver-mineralization', 'is_locked_out': False}, {'id': 2268, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-mass', 'is_locked_out': True}, {'id': 2275, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': False}, {'id': 2360, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'HMG-false-positive', 'is_locked_out': False}, {'id': 2368, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'liver-mass', 'is_locked_out': False}, {'id': 2401, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'pylorus-displacement', 'is_locked_out': True}, {'id': 2410, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'summation-structures', 'is_locked_out': False}, {'id': 2414, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'caudal-vena-cana-sm', 'is_locked_out': False}, {'id': 2423, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'liver-mineralization-gb', 'is_locked_out': False}, {'id': 2436, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'ileus-diffuse-distension-SI', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2454, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'SI-bunching', 'is_locked_out': False}, {'id': 2483, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'gastric-fb', 'is_locked_out': False}, {'id': 2500, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fluid-wispy', 'is_locked_out': False}, {'id': 2501, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'focal-loss-detail', 'is_locked_out': False}, {'id': 2560, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'splenic-nodule', 'is_locked_out': False}, {'id': 2562, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'splenic-mass', 'is_locked_out': False}, {'id': 2568, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Gastric wall thickening', 'is_locked_out': False}, {'id': 2642, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'spondylosis-bridging', 'is_locked_out': False}, {'id': 2643, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hmg-severe', 'is_locked_out': False}, {'id': 2644, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hmg-mild', 'is_locked_out': False}, {'id': 2669, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Mild small intestinal distention', 'is_locked_out': False}, {'id': 2714, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Gall bladder emphysema', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nMineralization noted in the liver is suspected to be associated with the gallbladder, representative of cholelithiasis. The hepatic rounded edges noted may be secondary to extrahepatic bile duct obstruction/ slight hepatomegaly. Neoplasia or a benign hepatopathy with incidental cholelithiasis cannot be ruled out.\nGiven the normal appearance of the GI tract, the focal loss of detail in the right cranial abdomen, and the clinical history provided, clinical signs may be consistent with concurrent pancreatitis. No evidence of intestinal foreign body or intestinal obstruction is noted. Other differentials include gastroenteritis due to inflammatory, dietary indiscretion, toxin, infectious, or parasitic causes.\nGastric material. This is most consistent with digested food; however, non-obstructive foreign or foreign material mixed with food cannot be ruled out.\nA small vena cava likely indicates hypovolemia.\nBridging spondylosis is noted. Likely incidental.\n\nRecommendations:\nAbdominal ultrasound is recommended for further investigation of hepatomegaly, pancreatitis, and hepatic mineralization. An FNA sampling, or more likely a biopsy, may also be necessary for a definitive diagnosis. Supportive medical management for pancreatitis and close monitoring of the patient is recommended\nIf warranted, consider repeat fasting abdominal radiographs in 12-24 hours to assess gastric emptying and rule out the presence of obstructive foreign material.\nStabilize the patient with supportive care including; IV fluids (crystalloids and +/- colloids), supplemental oxygen, blood transfusion if indicated. Correlate with other clinical findings, blood work, blood pressure monitoring and ECG.\nCorrelate with physical exam findings to determine the clinical significance of this bridging spondylosis.'}

{'bday': '2014-09-05', 'name': 'Pinto', 'breed': 'MIXED', 'owner': 'Osollo', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}

{'name': 'Animal Emergency Clinic of Pasadena', 'email': '[email protected]', 'address': 'United States - Pasadena', 'clinician': 'Kristie Villicana'}

History of inappetance x 1 week. VOmiting today, no diarrhea. Icteric pinnae, tense on abdominal palpation. CBC: WBC +59.84 ( 6-17), LYM +6.73 (1-4.8), MON +5.56 (0.2-1.5), NEU +47.35(3-12), RBC -3.66 (5.5-8.5), HGB -7.9 (12-18), HCT -25.02 (37-55), RDWc +22.6 (14-20), MPV +11.6 (3.9-11.1) CHEM: ALB -1.6 (2.5-4.4), ALP +1070 ( 20-150), ALT +633 (10-118), AMY +2822 ( 200-1200), TBIL +23.1 (0.1-0.6), GLOB -0.0 (2.3-5.2) Cpli: Abnormal

r/o post-hepatic icterus, pancreatitis/biliary obstruction

standard

['Gi signs - Systemic vs general']

['Icterus/jaundice', 'Vomiting', 'Hyporexia', 'Pain - abdominal', 'Elevated liver enzymes', 'Pancreatic Lipase tests/ cPLI/fPLI positive', 'Neutrophilia', 'Canine Medium/Large Breed']

[]

[113, 256, 607, 622, 2404, 2542, 2634, 2656]

[]

['Anemia']

[]

[659]

[]

[]

[]

[]

[]

{'patient': {'bday': '2016-08-30', 'name': 'Varner^Hoppi', 'breed': 'Domestic Shorthair', 'owner': 'Varner^Howard', 'gender': 'M', 'weight': '', 'species': 'Feline', 'neutered': 'UNALTERED', 'species_other': ''}, 'hospital': {'name': 'Crown UrgentVet', 'email': '[email protected]', 'address': 'United States - Mesa', 'clinician': 'Crown UrgentVet'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'Client reports that the cat had LTL lameness and inability to walk last night. The limb appears to be swollen and wants to rule out fracture/bone fragment, soft tissue injury or nerve injury or tumor', 'questions': 'Rule out fracture/bone fragment, solf tissue injury, tumor or nerve injury', 'specialty_area': ''}}

{'tags': {'userTags': ['expert_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'text', 'consults_sorting': 'auto', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1016, 'state': 'empty', 'source': 'rules'}, {'id': 1030, 'state': 'excluded', 'source': 'rules'}, {'id': 1031, 'state': 'excluded', 'source': 'rules'}, {'id': 1037, 'state': 'empty', 'source': 'rules'}, {'id': 1038, 'state': 'empty', 'source': 'rules'}, {'id': 1040, 'state': 'empty', 'source': 'rules'}, {'id': 1043, 'state': 'abnormal', 'source': 'rules'}, {'id': 1054, 'state': 'excluded', 'source': 'rules'}, {'id': 1095, 'state': 'excluded', 'source': 'rules'}, {'id': 1293, 'state': 'abnormal', 'source': 'rules'}], 'consult': [{'id': 225, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': None, 'elapsedTime': 61.965, 'consult_name': 'Incomplete study', 'isAddressingConcern': False, 'diagnosis_custom_text': '.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Comparative radiographs with the right limb may be of benefit. Often entheiopathy can be found bilaterally.', 'recommendation_custom_fields': None}, {'id': 394, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': None, 'elapsedTime': 90.81, 'consult_name': 'M/S Limb Fracture- Chip fracture', 'isAddressingConcern': True, 'diagnosis_custom_text': "A suspected chip fracture is identified, as evidenced by a small bony fragment separated from the main portion of the bone. However, enthesopathy is also possible and may be associated with the elbow's collateral ligament or flexor muscles. This does not rule out a soft tissue injury or neuropathy at this time.", 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Correlate with physical exam for clinical significance. Consider CT scan for further investigation of a possible chip fracture. Based on clinical signs, determine if splinting and exercise restriction may be adequate versus orthopedic consult and surgical intervention. ', 'recommendation_custom_fields': None}], 'signals': [{'id': 2327, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'feline'}, {'id': 2346, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'lameness-forelimb'}], 'findings': [{'id': 17, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': 'There is a displaced mineralization in the soft tissues of the left medial elbow epicondyle.', 'elapsedTime': 50.305, 'signal_name': 'fracture-limb-fracture', 'custom_fields': {'___s1_': ['displaced', 'chip'], '___s2_': ['left']}, 'finding_normal_text': 'No appendicular fractures are noted. ', 'finding_abnormal_text': 'There is a ___s1_ fracture of the ___s2_. '}, {'id': 723, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None, 'finding_normal_text': 'No aggressive osseous lesions identified. ', 'finding_abnormal_text': 'There is a bone lesion with evidence of ___s1_ identified in ___s2_. '}, {'id': 762, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'elbow-osteophytosis', 'custom_fields': None, 'finding_normal_text': 'There are no degenerative changes noted in the elbows. ', 'finding_abnormal_text': 'There are degenerative changes noted in the ___s1_ elbow. '}, {'id': 2275, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'soft-tissue-swelling', 'custom_fields': None, 'finding_normal_text': 'There is no soft tissue swelling. ', 'finding_abnormal_text': 'There is soft tissue swelling involving ___s1_. '}, {'id': 2299, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of degenerative joint disease. ', 'finding_abnormal_text': 'There is evidence of degenerative joint disease. '}, {'id': 2374, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'tail', 'custom_fields': None, 'finding_normal_text': 'The tail is normal in appearance with no evidence of fracture, luxation/subluxation, or aggressive lesions.', 'finding_abnormal_text': 'A ___s1_ is noted at the caudal vertebrae of the tail. '}, {'id': 2417, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': '.', 'elapsedTime': 114.932, 'signal_name': 'enthesopathy', 'custom_fields': {'___s1_': ['left']}, 'finding_normal_text': 'enthesopathy', 'finding_abnormal_text': 'There is bony proliferation/mineralization associated with the ___s1_. '}, {'id': 2446, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'carpal-metacarpal-osteophytosis', 'custom_fields': None, 'finding_normal_text': 'The carpal joints are unremarkable, no evidence of degenerative changes.', 'finding_abnormal_text': 'There is degenerative joint disease affecting the ___s1_ carpus. '}, {'id': 2600, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'Vertebral Subluxation', 'custom_fields': None, 'finding_normal_text': 'No evidence of vertebral subluxation is identified.', 'finding_abnormal_text': 'Vertebral subluxation is noted at ____. '}], 'diagnosis': [], 'questions': [{'id': 2674, 'source': 'labelling', 'attention': False, 'signal_name': 'trauma-fractures'}, {'id': 2677, 'source': 'labelling', 'attention': False, 'signal_name': 'lameness-frontLimb'}], 'recommendations': [], 'report_findings': 'There is a displaced mineralization noted in the soft tissues surrounding the left medial elbow epicondyle. No other abnormalities are observed in the rest of the musculoskeletal structures examined.', 'additionalSignals': [{'id': 2, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-bronchial-interstitial', 'is_locked_out': False}, {'id': 6, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': False}, {'id': 7, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pneumothorax', 'is_locked_out': False}, {'id': 9, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': False}, {'id': 10, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': False}, {'id': 12, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-distention', 'is_locked_out': False}, {'id': 13, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': False}, {'id': 14, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': False}, {'id': 15, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': False}, {'id': 16, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': False}, {'id': 17, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': True}, {'id': 20, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': False}, {'id': 699, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-mineralization', 'is_locked_out': False}, {'id': 700, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': False}, {'id': 702, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': False}, {'id': 703, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-mass', 'is_locked_out': False}, {'id': 708, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': False}, {'id': 713, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': False}, {'id': 714, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-diffuse-parenchymal', 'is_locked_out': False}, {'id': 715, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': False}, {'id': 723, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': False}, {'id': 738, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': False}, {'id': 740, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'colon-foreign-material', 'is_locked_out': False}, {'id': 762, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': True}, {'id': 764, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-osteophytosis', 'is_locked_out': False}, {'id': 783, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'right-heart-enlargement', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tracheal-narrowing', 'is_locked_out': False}, {'id': 790, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-luxation', 'is_locked_out': False}, {'id': 797, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-renomegaly', 'is_locked_out': False}, {'id': 798, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-small', 'is_locked_out': False}, {'id': 799, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'esophagus-distension', 'is_locked_out': False}, {'id': 870, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-gas', 'is_locked_out': False}, {'id': 873, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bronchiectasis', 'is_locked_out': False}, {'id': 879, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-gas', 'is_locked_out': True}, {'id': 880, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'general-cardiomegaly', 'is_locked_out': False}, {'id': 947, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-vhs', 'is_locked_out': False}, {'id': 1605, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': False}, {'id': 1635, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': False}, {'id': 1933, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': False}, {'id': 2141, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': False}, {'id': 2158, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-anomaly-class', 'is_locked_out': False}, {'id': 2159, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': False}, {'id': 2160, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': False}, {'id': 2166, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': False}, {'id': 2215, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'body-score', 'is_locked_out': False}, {'id': 2230, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-subluxation', 'is_locked_out': False}, {'id': 2231, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-neck-thicking', 'is_locked_out': False}, {'id': 2252, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'patellar-luxation', 'is_locked_out': False}, {'id': 2255, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pulmonary-vessel-congestion', 'is_locked_out': False}, {'id': 2259, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2266, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'axial-fracture', 'is_locked_out': False}, {'id': 2268, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-mass', 'is_locked_out': True}, {'id': 2272, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'muscle-atrophy', 'is_locked_out': False}, {'id': 2275, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': True}, {'id': 2292, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'wire-foreign-body', 'is_locked_out': False}, {'id': 2293, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bates-body', 'is_locked_out': False}, {'id': 2302, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'ununited-anconeal-process', 'is_locked_out': False}, {'id': 2303, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hypertrophic-osteodystrophy', 'is_locked_out': False}, {'id': 2304, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'panosteitis', 'is_locked_out': False}, {'id': 2306, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'palate-canals', 'is_locked_out': False}, {'id': 2364, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fragmented-medial-coronoid', 'is_locked_out': False}, {'id': 2374, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'tail', 'is_locked_out': False}, {'id': 2375, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'angular-limb-deformity', 'is_locked_out': False}, {'id': 2401, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pylorus-displacement', 'is_locked_out': False}, {'id': 2402, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'mineralized-disk', 'is_locked_out': False}, {'id': 2412, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-mineralization', 'is_locked_out': False}, {'id': 2417, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'enthesopathy', 'is_locked_out': False}, {'id': 2418, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lumbosacral-degeneration', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': True}, {'id': 2448, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pulmonary-vessel-mineralization', 'is_locked_out': False}, {'id': 2449, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pleural-fissure', 'is_locked_out': False}, {'id': 2483, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'gastric-fb', 'is_locked_out': False}, {'id': 2486, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spinal-articular-process-arthritis', 'is_locked_out': False}, {'id': 2496, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'Larynx-mineralization', 'is_locked_out': False}, {'id': 2498, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'Lumbosacral-stenosis', 'is_locked_out': False}, {'id': 2499, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Sacroiliac-luxation', 'is_locked_out': False}, {'id': 2567, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'Pulmonary Minerazliation', 'is_locked_out': False}, {'id': 2570, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'Incomplete study/missing orthogonal view', 'is_locked_out': False}, {'id': 2598, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Fracture Healing, callus', 'is_locked_out': False}, {'id': 2599, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'Tracheal Foreign Body', 'is_locked_out': False}, {'id': 2600, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Vertebral Subluxation', 'is_locked_out': False}, {'id': 2603, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'Pharynx Narrowing', 'is_locked_out': False}, {'id': 2641, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-dish', 'is_locked_out': False}, {'id': 2642, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-bridging', 'is_locked_out': False}, {'id': 2645, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'agressive-bone-lesion-discospondylitis', 'is_locked_out': False}], 'report_conclusions': "A small bony fragment appears separated from the main bone structure, suggestive of a chip fracture. Differential considerations include enthesopathy, potentially involving the elbow's collateral ligament or flexor muscle group. Concurrent soft tissue injury or neuropathy cannot be excluded at this stage.\n\nAdditional recommendations:\nComparative radiographs of the contralateral limb are recommended to assess for potential bilateral enthesiopathy. Clinical correlation through physical examination is advised to evaluate the significance of the findings. Further delineation of a suspected chip fracture may be achieved with computed tomography (CT). Depending on the clinical presentation, management options may range from conservative measures such as splinting and exercise restriction to consideration of an orthopedic consultation for potential surgical intervention."}

{'bday': '2016-08-30', 'name': 'Varner^Hoppi', 'breed': 'Domestic Shorthair', 'owner': 'Varner^Howard', 'gender': 'M', 'weight': '', 'species': 'Feline', 'neutered': 'UNALTERED', 'species_other': ''}

{'name': 'Crown UrgentVet', 'email': '[email protected]', 'address': 'United States - Mesa', 'clinician': 'Crown UrgentVet'}

Client reports that the cat had LTL lameness and inability to walk last night. The limb appears to be swollen and wants to rule out fracture/bone fragment, soft tissue injury or nerve injury or tumor

Rule out fracture/bone fragment, solf tissue injury, tumor or nerve injury

standard

['trauma-fractures', 'lameness-frontLimb']

['Feline', 'Forelimb lameness']

[]

[2327, 2346]

[]

[]

[]

[]

[]

[]

[]

[]

[]

{'patient': {'bday': '2023-06-30', 'name': 'moca', 'breed': 'French Bulldog', 'owner': 'hazzard', 'gender': 'F', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}, 'hospital': {'name': 'Miami Shores Animal Clinic', 'email': '[email protected]', 'clinician': 'MIAMI SHORES ANIMAL CLINIC'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'VOMITING CONSTANTLY SINCE 2 DAYS AGO, ANOREXIC ', 'questions': 'POSSIBLE GASTRAITIS VS PANCRETITIS', 'specialty_area': ''}}

{'tags': {'userTags': ['standard_level'], 'difficulty': 'standard', 'consults_mode': 'coded', 'findings_mode': 'coded', 'consults_sorting': 'manual', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1015, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1022, 'state': 'inprogress', 'source': 'labelling'}, {'id': 1023, 'state': 'empty', 'source': 'labelling'}, {'id': 1025, 'state': 'abnormal', 'source': 'rules'}, {'id': 1026, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1032, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1035, 'state': 'inprogress', 'source': 'labelling'}, {'id': 1036, 'state': 'partial', 'source': 'labelling'}, {'id': 1041, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1044, 'state': 'partial', 'source': 'labelling'}, {'id': 1053, 'state': 'inprogress', 'source': 'labelling'}], 'consult': [{'id': 359, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': 5, 'consult_name': 'Hindlimb Stifle - fp patella lux, positioning', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 365, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': 4, 'consult_name': 'Hindlimb Hip - hip subluxation', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 696, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': 3, 'consult_name': 'Spine - TID/CID with VAN', 'diagnosis_custom_text': 'Presence of disc space narrowing associated with vertebral anomaly\xa0ventral spondylosis\xa0 is suggestive of disc degeneration.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1107, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': 2, 'consult_name': 'Intestines - Normal, vomiting, gastroenteritis, no HGE', 'diagnosis_custom_text': 'Given the clinical history provided, clinical signs may be consistent with a gastroenteritis. No obstructive pattern is visible although a GI obstruction cannot be completely excluded on radiographs. Gastroenteritis due to infectious conditions, a systemic illness, and dietary indiscretion should be considered.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1160, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': 1, 'consult_name': 'Gastric - Soft tissue FB vs. Rugal folds vs. fluid', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}], 'signals': [{'id': 256, 'source': 'ai', 'history': False, 'confidence': 3, 'signal_name': 'Vomiting'}, {'id': 606, 'source': 'ai', 'history': False, 'confidence': 3, 'signal_name': 'Anorexia'}, {'id': 2654, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'small-breed'}], 'findings': [{'id': 9, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'spondylosis-spondylosis', 'custom_fields': {'___s1_': ['thoracolumbar']}}, {'id': 11, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bladder-bladder-stone', 'custom_fields': None}, {'id': 17, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-limb-fracture', 'custom_fields': None}, {'id': 20, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'liver-hepatomegaly', 'custom_fields': None}, {'id': 702, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'spleen-splenomegaly', 'custom_fields': None}, {'id': 723, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None}, {'id': 733, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'esophagus-foreign-body', 'custom_fields': None}, {'id': 1605, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'stomach-n-gastric-material', 'custom_fields': {'___s1_': ['digested food admixed with unidentified soft tissue material']}}, {'id': 1932, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-mass-effect', 'custom_fields': None}, {'id': 1933, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-limited-detail', 'custom_fields': None}, {'id': 2141, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-thoracic-mass', 'custom_fields': None}, {'id': 2158, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'vert-anomaly-class', 'custom_fields': {'___s1_': ['multiple thoracic vertebrae']}}, {'id': 2160, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-diaphragmatic-hernia', 'custom_fields': None}, {'id': 2230, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'hip-subluxation', 'custom_fields': {'___s1_': ['left and right']}}, {'id': 2231, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-neck-thicking', 'custom_fields': None}, {'id': 2252, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'patellar-luxation', 'custom_fields': {'___s1_': ['lateral'], '___s2_': ['left']}}, {'id': 2284, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'pleural-space', 'custom_fields': None}, {'id': 2295, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'kidney-margins', 'custom_fields': None}, {'id': 2296, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'urolithiasis', 'custom_fields': None}, {'id': 2298, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'intervertebral-disc-space', 'custom_fields': {'___s1_': ['multiple areas in the thoracic spine']}}, {'id': 2299, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None}, {'id': 2500, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fluid-wispy', 'custom_fields': None}], 'diagnosis': [{'id': 138, 'state': 'abnormal', 'source': 'ai', 'history': False, 'confidence': 100, 'diagnosis_name': 'Gastritis'}, {'id': 149, 'state': 'abnormal', 'source': 'ai', 'history': False, 'confidence': 100, 'diagnosis_name': 'Pancreatitis'}], 'questions': [{'id': 2661, 'source': 'labelling', 'signal_name': 'Gi signs - Systemic vs general'}], 'recommendations': [], 'report_findings': 'Thorax\nThe observed thorax is within normal limits. No abnormal thoracic findings are noted.\n\nAbdomen\nThere is radiopaque material within the stomach which has the appearance of digested food admixed with unidentified soft tissue material. The rest of the observed abdomen is within normal limits.\n\nMusculoskeletal\nThere is intervertebral disc space narrowing at multiple areas in the thoracic spine. There is spondylosis deformans noted in the thoracolumbar spine. Vertebral anomaly is noted at multiple thoracic vertebrae. There is evidence of hip incongruity of the left and right hip. There is lateral patellar luxation noted in the left knee. The rest of the observed musculoskeletal system is within normal limits.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': True}, {'id': 7, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-pneumothorax', 'is_locked_out': True}, {'id': 9, 'source': 'labelling', 'history': False, 'confidence': 2, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': True}, {'id': 10, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': True}, {'id': 12, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'stomach-n-distention', 'is_locked_out': True}, {'id': 13, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': True}, {'id': 14, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': True}, {'id': 15, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': True}, {'id': 16, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': True}, {'id': 17, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': True}, {'id': 699, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'kidney-mineralization', 'is_locked_out': True}, {'id': 701, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': True}, {'id': 702, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': True}, {'id': 703, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-mass', 'is_locked_out': False}, {'id': 708, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 709, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'retroperitoneal-lymphadenopathy', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': False}, {'id': 713, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': True}, {'id': 715, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': True}, {'id': 723, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': True}, {'id': 738, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': True}, {'id': 762, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'knee-osteophytosis', 'is_locked_out': True}, {'id': 787, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'tracheal-narrowing', 'is_locked_out': False}, {'id': 790, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'hip-luxation', 'is_locked_out': True}, {'id': 797, 'source': 'ray', 'history': False, 'confidence': -2, 'signal_name': 'kidney-renomegaly', 'is_locked_out': True}, {'id': 798, 'source': 'ray', 'history': False, 'confidence': -2, 'signal_name': 'kidney-small', 'is_locked_out': True}, {'id': 799, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'esophagus-distension', 'is_locked_out': True}, {'id': 870, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-gas', 'is_locked_out': True}, {'id': 873, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'bronchiectasis', 'is_locked_out': False}, {'id': 880, 'source': 'ray', 'history': False, 'confidence': -2, 'signal_name': 'general-cardiomegaly', 'is_locked_out': True}, {'id': 947, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'heart-vhs', 'is_locked_out': False}, {'id': 1605, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': True}, {'id': 1633, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'uterus-distension', 'is_locked_out': False}, {'id': 1635, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': True}, {'id': 1933, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': True}, {'id': 1937, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'spleen-visible', 'is_locked_out': False}, {'id': 2141, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': True}, {'id': 2158, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': False}, {'id': 2160, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': True}, {'id': 2166, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': False}, {'id': 2215, 'source': 'ray', 'history': False, 'confidence': 2, 'signal_name': 'body-score', 'is_locked_out': True}, {'id': 2229, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'hip-dysplasia', 'is_locked_out': True}, {'id': 2230, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'hip-subluxation', 'is_locked_out': True}, {'id': 2231, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'hip-neck-thicking', 'is_locked_out': True}, {'id': 2252, 'source': 'ray', 'history': False, 'confidence': 2, 'signal_name': 'patellar-luxation', 'is_locked_out': True}, {'id': 2259, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2262, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'small-liver', 'is_locked_out': False}, {'id': 2263, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'liver-mineralization', 'is_locked_out': False}, {'id': 2275, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': False}, {'id': 2292, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'wire-foreign-body', 'is_locked_out': False}, {'id': 2293, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'bates-body', 'is_locked_out': False}, {'id': 2410, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'summation-structures', 'is_locked_out': False}, {'id': 2412, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'joint-mineralization', 'is_locked_out': False}, {'id': 2423, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'liver-mineralization-gb', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2449, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'pleural-fissure', 'is_locked_out': False}, {'id': 2459, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spina-bifida', 'is_locked_out': False}, {'id': 2483, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'gastric-fb', 'is_locked_out': True}, {'id': 2486, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spinal-articular-process-arthritis', 'is_locked_out': False}, {'id': 2500, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'fluid-wispy', 'is_locked_out': False}, {'id': 2501, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'focal-loss-detail', 'is_locked_out': False}, {'id': 2556, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'Abdominal mineralization', 'is_locked_out': False}, {'id': 2560, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'splenic-nodule', 'is_locked_out': False}, {'id': 2562, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'splenic-mass', 'is_locked_out': False}, {'id': 2569, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'False positive limited abdominal detail', 'is_locked_out': False}, {'id': 2637, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'Distal fabella displacement', 'is_locked_out': False}, {'id': 2641, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'spondylosis-dish', 'is_locked_out': True}, {'id': 2642, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spondylosis-bridging', 'is_locked_out': False}, {'id': 2693, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'vert-lumbar-narrowing-fp', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nA small, soft-tissue opacity, is noted within the stomach. This may represent food/fluid or rugal folds in the stomach however foreign material cannot be entirely ruled out.\nGiven the clinical history provided, clinical signs may be consistent with a gastroenteritis. No obstructive pattern is visible although a GI obstruction cannot be completely excluded on radiographs. Gastroenteritis due to infectious conditions, a systemic illness, and dietary indiscretion should be considered.\nPresence of disc space narrowing associated with vertebral anomaly\xa0ventral spondylosis\xa0 is suggestive of disc degeneration.\nEvidence of hip subluxation/joint laxity.\nPresumed patella displacement from positioning.\n\nRecommendations:\nCorrelate with history of the patients last meal and consider an abdominal ultrasound for further investigation. Alternatively, repeat fasting abdominal radiographs in 12-24 hours to assess gastric emptying can also be considered.\nMedical management of the reported clinical signs is indicated at this time. If there is no response to medical management, consider repeat radiographs and/or abdominal ultrasound to further assess gastrointestinal pattern and lab testing for pancreatitis.\nConsider advanced imaging such as MRI for further investigation of the disc space narrowing associated with vertebral anomaly. Correlate with physical exam findings.\nCorrelate with orthopedic examination for further evaluation of hip subluxation/joint laxity.\nIf there is concern for patellar luxation, consider repeat radiographs with pelvic limbs extended caudally.'}

{'bday': '2023-06-30', 'name': 'moca', 'breed': 'French Bulldog', 'owner': 'hazzard', 'gender': 'F', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}

{'name': 'Miami Shores Animal Clinic', 'email': '[email protected]', 'clinician': 'MIAMI SHORES ANIMAL CLINIC'}

VOMITING CONSTANTLY SINCE 2 DAYS AGO, ANOREXIC

POSSIBLE GASTRAITIS VS PANCRETITIS

standard

['Gi signs - Systemic vs general']

['Vomiting', 'Anorexia', 'Canine Small Breed']

[]

[256, 606, 2654]

[]

['Gastritis', 'Pancreatitis']

[]

[138, 149]

[]

[]

[]

[]

[]

{'patient': {'bday': '2018-10-01', 'name': 'WILLYS', 'breed': 'English Bulldog', 'owner': 'CLAIR', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}, 'hospital': {'name': 'Affordable Animal Emergency Clinic in Auburn', 'email': '[email protected]', 'clinician': 'Dr. Rule'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'Vomited\xa0partially digested food. \xa0Started with diarrhea 4 days ago. \xa0Fecal sample brought to pine tree vet. \xa0In house fecal negative for parasites. \xa0Referral lab panel pending. \xa0Vomited once last night and several times today, food and some bile.\r\n\r\n\r\n\r\n', 'questions': 'R/O: \xa0GI obstruction, pancreatitis, gastroenteritis. \xa0CBC/Chem17/Lytes/cPL pending.', 'specialty_area': ''}}

{'tags': {'userTags': ['standard_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'coded', 'consults_sorting': 'auto', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1015, 'state': 'abnormal', 'source': 'rules'}, {'id': 1025, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1026, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1029, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1036, 'state': 'abnormal', 'source': 'labelling'}], 'consult': [{'id': 244, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': None, 'consult_name': 'Intestines - 2 pops, poss(less confident), no obvious FB', 'diagnosis_custom_text': 'The changes noted in the small intestines is suspicious for a two populations of small intestine. This most commonly represents a mechanical obstruction though severe enteritis cannot always be ruled out. No obvious foreign body is noted.\xa0Gastroenteritis, pancreatitis or a systemic illness causing secondary GI signs can not be ruled out completely.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 458, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': None, 'consult_name': 'Bladder - Bladder stones, fp', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 696, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': None, 'consult_name': 'Spine - TID/CID with VAN', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1231, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': None, 'consult_name': 'Gastric - bones in the stomach', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1251, 'state': 'abnormal', 'source': 'labelling', 'custom_sort': None, 'consult_name': 'Spine general - Bridging spondylosis, no pain', 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}], 'signals': [{'id': 76, 'source': 'ai', 'history': False, 'confidence': 3, 'signal_name': 'Diarrhea-c'}, {'id': 256, 'source': 'ai', 'history': False, 'confidence': 3, 'signal_name': 'Vomiting'}, {'id': 2352, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'lab-work-pending'}, {'id': 2654, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'small-breed'}], 'findings': [{'id': 9, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'spondylosis-spondylosis', 'custom_fields': {'___s1_': ['thoracic', 'lumbar', 'lumbosacral']}}, {'id': 15, 'source': 'rules', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'intestines-small-obstruction', 'custom_fields': None}, {'id': 20, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'liver-hepatomegaly', 'custom_fields': None}, {'id': 702, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'spleen-splenomegaly', 'custom_fields': None}, {'id': 723, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None}, {'id': 739, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'stomach-n-foreign-material', 'custom_fields': {'___s1_': ['mineralized'], '___s2_': ['that has the appearance of bone shards']}}, {'id': 1932, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-mass-effect', 'custom_fields': None}, {'id': 1933, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-limited-detail', 'custom_fields': None}, {'id': 2158, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'vert-anomaly-class', 'custom_fields': {'___s1_': ['multiple thoracic vertebrae']}}, {'id': 2295, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'kidney-margins', 'custom_fields': None}, {'id': 2296, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'urolithiasis', 'custom_fields': None}, {'id': 2298, 'source': 'labelling', 'history': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'intervertebral-disc-space', 'custom_fields': {'___s1_': ['T11-T12', 'T12-T13', 'T13-L1', 'L1-L2', 'L2-L3']}}, {'id': 2299, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None}, {'id': 2316, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'intestine-fm', 'custom_fields': None}, {'id': 2500, 'source': 'rules', 'history': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fluid-wispy', 'custom_fields': None}], 'diagnosis': [{'id': 59, 'state': 'abnormal', 'source': 'ai', 'history': False, 'confidence': 100, 'diagnosis_name': 'Intestinal obstruction'}, {'id': 143, 'state': 'abnormal', 'source': 'ai', 'history': False, 'confidence': 100, 'diagnosis_name': 'Gastroenteritis'}, {'id': 149, 'state': 'abnormal', 'source': 'ai', 'history': False, 'confidence': 100, 'diagnosis_name': 'Pancreatitis'}], 'questions': [{'id': 2661, 'source': 'labelling', 'signal_name': 'Gi signs - Systemic vs general'}], 'recommendations': [], 'report_findings': 'Abdomen\nThe stomach contains a mineralized opacity that has the appearance of bone shards. There is presence of distension of a portion of small intestine and a population of non-distended intestine. The rest of the observed abdomen is within normal limits.\n\nMusculoskeletal\nThere is intervertebral disc space narrowing at T11-T12, T12-T13, T13-L1, L1-L2 and L2-L3. There is spondylosis deformans noted in the thoracic, lumbar and lumbosacral spine. Vertebral anomaly is noted at multiple thoracic vertebrae. The rest of the observed musculoskeletal system is within normal limits.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': False}, {'id': 7, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-pneumothorax', 'is_locked_out': False}, {'id': 9, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': True}, {'id': 10, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': True}, {'id': 12, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'stomach-n-distention', 'is_locked_out': True}, {'id': 13, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': True}, {'id': 14, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': True}, {'id': 15, 'source': 'ray', 'history': False, 'confidence': 2, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': True}, {'id': 16, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': False}, {'id': 17, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': False}, {'id': 19, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': True}, {'id': 699, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'kidney-mineralization', 'is_locked_out': True}, {'id': 700, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'labelling', 'history': False, 'confidence': 2, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': True}, {'id': 702, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': True}, {'id': 708, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': False}, {'id': 713, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': False}, {'id': 715, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': False}, {'id': 723, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': False}, {'id': 738, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': True}, {'id': 762, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'knee-osteophytosis', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'tracheal-narrowing', 'is_locked_out': False}, {'id': 790, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'hip-luxation', 'is_locked_out': False}, {'id': 797, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'kidney-renomegaly', 'is_locked_out': False}, {'id': 798, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'kidney-small', 'is_locked_out': False}, {'id': 799, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'esophagus-distension', 'is_locked_out': False}, {'id': 870, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-gas', 'is_locked_out': True}, {'id': 873, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'bronchiectasis', 'is_locked_out': False}, {'id': 879, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'subcutaneous-gas', 'is_locked_out': False}, {'id': 880, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'general-cardiomegaly', 'is_locked_out': False}, {'id': 947, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'heart-vhs', 'is_locked_out': False}, {'id': 1605, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': True}, {'id': 1633, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'uterus-distension', 'is_locked_out': False}, {'id': 1635, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': True}, {'id': 1933, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': True}, {'id': 1937, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'spleen-visible', 'is_locked_out': False}, {'id': 2141, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': False}, {'id': 2158, 'source': 'ray', 'history': False, 'confidence': 3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': False}, {'id': 2160, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': False}, {'id': 2166, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': False}, {'id': 2215, 'source': 'ray', 'history': False, 'confidence': -3, 'signal_name': 'body-score', 'is_locked_out': True}, {'id': 2230, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'hip-subluxation', 'is_locked_out': False}, {'id': 2231, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'hip-neck-thicking', 'is_locked_out': False}, {'id': 2252, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'patellar-luxation', 'is_locked_out': False}, {'id': 2259, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2260, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'fluid-distension-SI', 'is_locked_out': False}, {'id': 2265, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'urinary-bladder-distension', 'is_locked_out': False}, {'id': 2275, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': False}, {'id': 2371, 'source': 'labelling', 'history': False, 'confidence': 2, 'signal_name': 'bladder-calculi-fp', 'is_locked_out': False}, {'id': 2401, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'pylorus-displacement', 'is_locked_out': False}, {'id': 2436, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'ileus-diffuse-distension-SI', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2449, 'source': 'ray', 'history': False, 'confidence': 0, 'signal_name': 'pleural-fissure', 'is_locked_out': False}, {'id': 2454, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'SI-bunching', 'is_locked_out': False}, {'id': 2459, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spina-bifida', 'is_locked_out': False}, {'id': 2483, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'gastric-fb', 'is_locked_out': False}, {'id': 2486, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spinal-articular-process-arthritis', 'is_locked_out': False}, {'id': 2489, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'urinary-bladder-gas', 'is_locked_out': False}, {'id': 2500, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'fluid-wispy', 'is_locked_out': False}, {'id': 2502, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'Ureteral-stone', 'is_locked_out': False}, {'id': 2568, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'Gastric wall thickening', 'is_locked_out': False}, {'id': 2641, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'spondylosis-dish', 'is_locked_out': False}, {'id': 2642, 'source': 'labelling', 'history': False, 'confidence': 3, 'signal_name': 'spondylosis-bridging', 'is_locked_out': False}, {'id': 2669, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'Mild small intestinal distention', 'is_locked_out': False}, {'id': 2692, 'source': 'labelling', 'history': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing-fp', 'is_locked_out': False}, {'id': 2693, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'vert-lumbar-narrowing-fp', 'is_locked_out': False}, {'id': 2698, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'proximal-duodenum-distension', 'is_locked_out': False}, {'id': 2699, 'source': 'labelling', 'history': False, 'confidence': -3, 'signal_name': 'sio-colon', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nGastric distension with bone shards is noted in the study. Bone foreign bodies in the stomach can often fully dissolve.\nThe changes noted in the small intestines is suspicious for a two populations of small intestine. This most commonly represents a mechanical obstruction though severe enteritis cannot always be ruled out. No obvious foreign body is noted.\xa0Gastroenteritis, pancreatitis or a systemic illness causing secondary GI signs can not be ruled out completely.\nThe opacity over the bladder is suspected to be secondary to summation of structures or possible mineralization of surrounding structures rather than true urolithiasis.\nPresence of disc space narrowing associated with vertebral anomaly is suggestive of disc degeneration.\nBridging spondylosis is noted. Likely incidental.\n\nRecommendations:\nA conservative approach with supportive care is recommended. Repeat fasting abdominal radiographs in 12-24 hours to assess gastric emptying and monitor for potential obstruction in the intestines. Endoscopy may be attempted, but its success may be limited due to multiple fragments. Inducing emesis may be an option, but complications could arise. Surgical exploration of the abdomen for removal may need to be considered.\n Medical management with follow-up radiographs may be a consideration if the patient is closely monitored for any change in status.\nConsider biochemistry profile and urinalysis +/- abdominal ultrasound if there is suspicion for urinary bladder calculi.\nConsider advanced imaging such as MRI for further investigation of the disc space narrowing associated with vertebral anomaly. Correlate with physical exam findings.\nCorrelate with physical exam findings to determine the clinical significance of this bridging spondylosis.'}

{'bday': '2018-10-01', 'name': 'WILLYS', 'breed': 'English Bulldog', 'owner': 'CLAIR', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}

{'name': 'Affordable Animal Emergency Clinic in Auburn', 'email': '[email protected]', 'clinician': 'Dr. Rule'}

Vomited partially digested food.  Started with diarrhea 4 days ago.  Fecal sample brought to pine tree vet.  In house fecal negative for parasites.  Referral lab panel pending.  Vomited once last night and several times today, food and some bile.

R/O:  GI obstruction, pancreatitis, gastroenteritis.  CBC/Chem17/Lytes/cPL pending.

standard

['Gi signs - Systemic vs general']

['Diarrhea', 'Vomiting', 'Lab work pending', 'Canine Small Breed']

[]

[76, 256, 2352, 2654]

[]

['Intestinal obstruction', 'Gastroenteritis', 'Pancreatitis']

[]

[59, 143, 149]

[]

[]

[]

[]

[]

{'patient': {'bday': '2019-08-27', 'name': 'Brunett^Charlie', 'breed': 'Bulldog', 'owner': 'Brunett^Sean', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}, 'hospital': {'name': 'PetCheck Urgent Care - Deptford', 'email': '[email protected]', 'address': 'United States - Deptford', 'clinician': 'Erin Paul'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'Left hind leg lameness for 2 weeks \r\n4DX- negative \r\nResponded to NSAID and gabapentin\r\nHeard a click upon examination ', 'questions': '.', 'specialty_area': ''}}

{'tags': {'userTags': [], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'text', 'consults_sorting': 'auto', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1005, 'state': 'empty', 'source': 'rules'}, {'id': 1030, 'state': 'inprogress', 'source': 'rules'}, {'id': 1032, 'state': 'empty', 'source': 'rules'}, {'id': 1041, 'state': 'abnormal', 'source': 'rules'}, {'id': 1054, 'state': 'inprogress', 'source': 'rules'}, {'id': 1095, 'state': 'inprogress', 'source': 'rules'}], 'consult': [{'id': 352, 'state': 'abnormal', 'source': 'labelling', 'attention': False, 'custom_sort': None, 'elapsedTime': 66.049, 'consult_name': 'Hindlimb Stifle - Chronic cruciate, lameness', 'isAddressingConcern': True, 'diagnosis_custom_text': 'Osteoarthritis of the indicated stifle along with increased soft tissue opacity noted is most consistent with chronic stifle instability and intra-articular injury. This is commonly associated with cranial cruciate ligament injury/rupture. There appears to be possible patellar luxation of the left patellar however there is some degree of rotation of the limb, so this appearance maybe attributed to positioning.', 'diagnosis_custom_fields': None, 'recommendation_custom_text': 'Correlate with orthopedic examination to assess for cranial drawer in the stifle.\xa0If there is concern for patellar luxation, consider repeat radiographs with pelvic limbs extended caudally.', 'recommendation_custom_fields': None}], 'signals': [{'id': 2185, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'Lameness'}, {'id': 2345, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'lameness-hind-limb'}, {'id': 2656, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'medium-large-breed'}, {'id': 2657, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'brachycephalic'}], 'findings': [{'id': 10, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'knee-joint-effusion', 'custom_fields': {'___s1_': ['moderate'], '___s2_': ['left']}, 'finding_normal_text': 'No stifle effusion is identified. ', 'finding_abnormal_text': 'There is a ___s1_ increased soft tissue opacity in the stifle joint noted in the ___s2_ stifle. '}, {'id': 17, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-limb-fracture', 'custom_fields': None, 'finding_normal_text': 'No appendicular fractures are noted. ', 'finding_abnormal_text': 'There is a ___s1_ fracture of the ___s2_. '}, {'id': 723, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None, 'finding_normal_text': 'No aggressive osseous lesions identified. ', 'finding_abnormal_text': 'There is a bone lesion with evidence of ___s1_ identified in ___s2_. '}, {'id': 764, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'knee-osteophytosis', 'custom_fields': {'___s1_': ['left and right']}, 'finding_normal_text': 'There is no evidence of degenerative changes within the stifle. ', 'finding_abnormal_text': 'There are degenerative changes noted in the ___s1_ stifle. '}, {'id': 870, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'custom_fields': None, 'finding_normal_text': 'The tarsal joints are unremarkable, no evidence of degenerative changes.', 'finding_abnormal_text': 'There is degenerative joint disease affecting the ___s1_ tarsus. '}, {'id': 2231, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-neck-thicking', 'custom_fields': None, 'finding_normal_text': 'There are no degenerative changes noted in the coxofemoral joints. ', 'finding_abnormal_text': 'There are degenerative changes affecting the ___s1_ coxofemoral joint. '}, {'id': 2252, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': True, 'confidence': '3', 'custom_text': 'Possible lateral patellar luxation noted in the left knee. ', 'elapsedTime': 6.652, 'signal_name': 'patellar-luxation', 'custom_fields': {'___s1_': ['lateral'], '___s2_': ['left']}, 'finding_normal_text': 'The patella is located in a normal position. ', 'finding_abnormal_text': 'There is ___s1_ patellar luxation noted in the ___s2_ knee. '}, {'id': 2275, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'soft-tissue-swelling', 'custom_fields': None, 'finding_normal_text': 'There is no soft tissue swelling. ', 'finding_abnormal_text': 'There is soft tissue swelling involving ___s1_. '}, {'id': 2300, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'coxofemoral-pelvis', 'custom_fields': None, 'finding_normal_text': 'The coxofemoral joints and pelvis are unremarkable. ', 'finding_abnormal_text': 'hoa, hlx, pfx, not hic'}, {'id': 2600, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'Vertebral Subluxation', 'custom_fields': None, 'finding_normal_text': 'No evidence of vertebral subluxation is identified.', 'finding_abnormal_text': 'Vertebral subluxation is noted at ____. '}], 'diagnosis': [], 'questions': [{'id': 2678, 'source': 'labelling', 'attention': False, 'signal_name': 'lameness-hindLimb'}], 'recommendations': [], 'report_findings': 'Musculoskeletal\nThere is a moderately increased soft tissue opacity in the left stifle joint, and degenerative changes are noted in the left and right stifle. Possible lateral patellar luxation was noted in both stifles. The rest of the observed musculoskeletal system is within normal limits.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': False}, {'id': 7, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pneumothorax', 'is_locked_out': False}, {'id': 9, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': False}, {'id': 10, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'knee-joint-effusion', 'is_locked_out': True}, {'id': 11, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': False}, {'id': 12, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-distention', 'is_locked_out': False}, {'id': 13, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': False}, {'id': 14, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': False}, {'id': 15, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': False}, {'id': 16, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': True}, {'id': 17, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': False}, {'id': 699, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-mineralization', 'is_locked_out': False}, {'id': 700, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': False}, {'id': 702, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': False}, {'id': 703, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-mass', 'is_locked_out': False}, {'id': 708, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': False}, {'id': 713, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': False}, {'id': 715, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': False}, {'id': 723, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': False}, {'id': 738, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': False}, {'id': 740, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'colon-foreign-material', 'is_locked_out': False}, {'id': 762, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'knee-osteophytosis', 'is_locked_out': True}, {'id': 783, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'right-heart-enlargement', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tracheal-narrowing', 'is_locked_out': False}, {'id': 790, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-luxation', 'is_locked_out': True}, {'id': 797, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-renomegaly', 'is_locked_out': False}, {'id': 798, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'kidney-small', 'is_locked_out': False}, {'id': 799, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'esophagus-distension', 'is_locked_out': False}, {'id': 870, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -2, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': True}, {'id': 871, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-gas', 'is_locked_out': False}, {'id': 873, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'bronchiectasis', 'is_locked_out': False}, {'id': 879, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-gas', 'is_locked_out': True}, {'id': 880, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'general-cardiomegaly', 'is_locked_out': False}, {'id': 947, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-vhs', 'is_locked_out': False}, {'id': 1605, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': False}, {'id': 1635, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'prostate-visible', 'is_locked_out': False}, {'id': 1932, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': False}, {'id': 1933, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': False}, {'id': 2141, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': False}, {'id': 2158, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': False}, {'id': 2160, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': False}, {'id': 2166, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': False}, {'id': 2230, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'hip-subluxation', 'is_locked_out': False}, {'id': 2231, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-neck-thicking', 'is_locked_out': True}, {'id': 2252, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'patellar-luxation', 'is_locked_out': True}, {'id': 2259, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2266, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'axial-fracture', 'is_locked_out': False}, {'id': 2271, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-luxation', 'is_locked_out': False}, {'id': 2272, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'muscle-atrophy', 'is_locked_out': False}, {'id': 2275, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': True}, {'id': 2301, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'osteochondritis-dissecans', 'is_locked_out': False}, {'id': 2303, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hypertrophic-osteodystrophy', 'is_locked_out': False}, {'id': 2304, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'panosteitis', 'is_locked_out': False}, {'id': 2401, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pylorus-displacement', 'is_locked_out': False}, {'id': 2402, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'mineralized-disk', 'is_locked_out': False}, {'id': 2412, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-mineralization', 'is_locked_out': False}, {'id': 2417, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'enthesopathy', 'is_locked_out': False}, {'id': 2418, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lumbosacral-degeneration', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2449, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'pleural-fissure', 'is_locked_out': False}, {'id': 2483, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'gastric-fb', 'is_locked_out': False}, {'id': 2498, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Lumbosacral-stenosis', 'is_locked_out': False}, {'id': 2600, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Vertebral Subluxation', 'is_locked_out': False}, {'id': 2637, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Distal fabella displacement', 'is_locked_out': False}, {'id': 2641, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-dish', 'is_locked_out': False}, {'id': 2642, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'spondylosis-bridging', 'is_locked_out': False}, {'id': 2645, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'agressive-bone-lesion-discospondylitis', 'is_locked_out': False}, {'id': 2653, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Fragmented-fabella', 'is_locked_out': False}, {'id': 2666, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': "Hypertrophic osteopathy (Marie's disease)", 'is_locked_out': False}, {'id': 2667, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-spine', 'is_locked_out': False}, {'id': 2710, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Patella luxation false positive', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nOsteoarthritis of the left stifle, along with increased soft tissue opacity noted, is most consistent with chronic stifle instability and intra-articular injury. This is commonly associated with cranial cruciate ligament injury/rupture. There appears to be possible patellar luxation. However, there is some degree of rotation of the limb, so this appearance may be attributed to positioning.\n\nRecommendations:\nCorrelate with orthopedic examination to assess for cranial drawer in the stifle.\xa0If there is a concern for patellar luxation, consider repeat radiographs with pelvic limbs extended caudally.'}

{'bday': '2019-08-27', 'name': 'Brunett^Charlie', 'breed': 'Bulldog', 'owner': 'Brunett^Sean', 'gender': 'M', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}

{'name': 'PetCheck Urgent Care - Deptford', 'email': '[email protected]', 'address': 'United States - Deptford', 'clinician': 'Erin Paul'}

Left hind leg lameness for 2 weeks 4DX- negative Responded to NSAID and gabapentin Heard a click upon examination

.

standard

['lameness-hindLimb']

['Lameness', 'Hindlimb lameness', 'Canine Medium/Large Breed', 'Brachycephalic']

[]

[2185, 2345, 2656, 2657]

[]

[]

[]

[]

[]

[]

[]

[]

[]

{'patient': {'bday': '2014-07-12', 'name': 'Shavet^Sophie', 'breed': 'Mixed', 'owner': 'Shavet^Malinda', 'gender': 'F', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}, 'hospital': {'name': 'Emergency Pet Care of Texas', 'email': '[email protected]', 'address': 'United States - Magnolia', 'clinician': 'Emergency Pet Care of Texas'}, 'accept_tos': 'true', 'consult_info': {'case_info': 'Sophie presented today for acute lameness on right hind leg. The owner reports that this evening, patient may have fallen off the couch and injured leg. Owner also reports that she tripped over patient this morning and patient cried out during episode but seems OK afterwards. \r\nSevere bruising and cellulitis on caudoventral abdomen extending into inguinal area and medial aspect of right hind leg. RPL has pitting edema present. Bilateral 4/4 luxating patellas', 'questions': '-Bilateral 4/4 luxating patellas. \r\n-Weight bearing lameness right hind leg.\r\n-bruising/cellulitis - spider bite? \r\n-Right hind leg has pitting edema \r\n-Splenic mass', 'specialty_area': ''}}

{'tags': {'userTags': [], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'text', 'consults_sorting': 'manual', 'unansweredAdditionalSignals': []}, 'groups': [{'id': 1005, 'state': 'empty', 'source': 'rules'}, {'id': 1019, 'state': 'abnormal', 'source': 'rules'}, {'id': 1022, 'state': 'inprogress', 'source': 'rules'}, {'id': 1023, 'state': 'abnormal', 'source': 'rules'}, {'id': 1030, 'state': 'inprogress', 'source': 'rules'}, {'id': 1032, 'state': 'empty', 'source': 'rules'}, {'id': 1035, 'state': 'empty', 'source': 'rules'}, {'id': 1038, 'state': 'empty', 'source': 'rules'}, {'id': 1041, 'state': 'inprogress', 'source': 'rules'}, {'id': 1043, 'state': 'abnormal', 'source': 'labelling'}, {'id': 1053, 'state': 'partial', 'source': 'rules'}, {'id': 1054, 'state': 'partial', 'source': 'rules'}, {'id': 1095, 'state': 'inprogress', 'source': 'rules'}], 'consult': [{'id': 200, 'state': 'abnormal', 'source': 'labelling', 'attention': True, 'custom_sort': 3, 'consult_name': 'Splenomegaly - Splenic mass/nodule', 'isAddressingConcern': True, 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 880, 'state': 'abnormal', 'source': 'labelling', 'attention': True, 'custom_sort': 2, 'consult_name': 'limited evaluation', 'isAddressingConcern': True, 'diagnosis_custom_text': "Limited evaluation of the right hindlimb and both patella's due to positioning (one the lateral images) and partial limb images on the VD view.\xa0", 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}, {'id': 1365, 'state': 'abnormal', 'source': 'labelling', 'attention': True, 'custom_sort': 1, 'consult_name': 'Subcut - Trauma(not bitten), subcut gas and swelling', 'isAddressingConcern': False, 'diagnosis_custom_text': None, 'diagnosis_custom_fields': None, 'recommendation_custom_text': None, 'recommendation_custom_fields': None}], 'signals': [{'id': 54, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'Bruising'}, {'id': 141, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Lump/swelling'}, {'id': 292, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Whining'}, {'id': 550, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'hematoma'}, {'id': 575, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'Mass/swelling - limb, upper'}, {'id': 2185, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'Lameness'}, {'id': 2345, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'lameness-hind-limb'}, {'id': 2474, 'source': 'ai', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'Edema- not specified'}, {'id': 2530, 'source': 'labelling', 'history': True, 'attention': False, 'confidence': 3, 'signal_name': 'patient-fell'}, {'id': 2656, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'medium-large-breed'}], 'findings': [{'id': 11, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bladder-bladder-stone', 'custom_fields': None, 'finding_normal_text': 'The urinary bladder is within normal limits. ', 'finding_abnormal_text': 'There is ___s1_ opacity noted over the silhouette of the urinary bladder. '}, {'id': 17, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-limb-fracture', 'custom_fields': None, 'finding_normal_text': 'No appendicular fractures are noted. ', 'finding_abnormal_text': 'There is a ___s1_ fracture of the ___s2_. '}, {'id': 20, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'liver-hepatomegaly', 'custom_fields': None, 'finding_normal_text': 'The liver is unremarkable. ', 'finding_abnormal_text': 'The liver appears enlarged. '}, {'id': 702, 'group': 'abdomen', 'source': 'labelling', 'history': False, 'attention': True, 'confidence': '3', 'custom_text': None, 'signal_name': 'spleen-splenomegaly', 'custom_fields': {'___s1_': ['mildly'], '___s2_': ['.']}, 'finding_normal_text': 'The spleen appears normal in size and contour. ', 'finding_abnormal_text': 'The spleen appears ___s1_ enlarged ___s2_ '}, {'id': 723, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'bone-lesion-lesion', 'custom_fields': None, 'finding_normal_text': 'No aggressive osseous lesions identified. ', 'finding_abnormal_text': 'There is a bone lesion with evidence of ___s1_ identified in ___s2_. '}, {'id': 733, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'esophagus-foreign-body', 'custom_fields': None, 'finding_normal_text': '.', 'finding_abnormal_text': 'A ___s1_ opacity foreign body is present in the ___s2_ esophagus.'}, {'id': 879, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'subcutaneous-gas', 'custom_fields': {'___s1_': ['ventral', 'abdominal wall']}, 'finding_normal_text': 'Subcutaneous gas', 'finding_abnormal_text': 'There is gas noted in the soft tissue of the ___s1_. '}, {'id': 880, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'general-cardiomegaly', 'custom_fields': None, 'finding_normal_text': 'The cardiac silhouette is normal in size and shape. ', 'finding_abnormal_text': 'There appears to be a generalized enlargement of the heart ___s1_'}, {'id': 947, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'heart-vhs', 'custom_fields': None, 'finding_normal_text': 'The cardiac silhouette is normal in size and shape. ', 'finding_abnormal_text': 'The heart measures above the normal range ___s1_'}, {'id': 1933, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'peritoneal-limited-detail', 'custom_fields': None, 'finding_normal_text': 'The serosal detail of the abdomen is normal. ', 'finding_abnormal_text': 'There is ___s1_ loss of serosal detail in the abdomen. '}, {'id': 2141, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-thoracic-mass', 'custom_fields': None, 'finding_normal_text': 'No pulmonary masses, lymphadenopathy, or mediastinal masses are noted. ', 'finding_abnormal_text': 'There ___s1_ noted in the ___s2_ thorax, ___s3_ '}, {'id': 2159, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fracture-rib-fracture', 'custom_fields': None, 'finding_normal_text': 'No evidence of rib fracture is observed.', 'finding_abnormal_text': 'There is ___s1_ fracture of the ___s2_ rib. '}, {'id': 2160, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-diaphragmatic-hernia', 'custom_fields': None, 'finding_normal_text': 'The diaphragm is unremarkable. ', 'finding_abnormal_text': 'There is evidence of herniation of abdominal organs into the thoracic cavity. The ___s1_ appears herniated into the ___s2_. '}, {'id': 2166, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'heart-left-atrial-enlarge', 'custom_fields': None, 'finding_normal_text': 'No left atrial enlargement is present.', 'finding_abnormal_text': 'There is evidence of left atrial enlargement.'}, {'id': 2230, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-subluxation', 'custom_fields': None, 'finding_normal_text': 'There is adequate acetabular coverage of the femoral heads with no subluxation noted. ', 'finding_abnormal_text': 'There is evidence of hip incongruity of the ___s1_ hip. '}, {'id': 2231, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'hip-neck-thicking', 'custom_fields': None, 'finding_normal_text': 'There are no degenerative changes noted in the coxofemoral joints. ', 'finding_abnormal_text': 'There are degenerative changes affecting the ___s1_ coxofemoral joint. '}, {'id': 2255, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'pulmonary-vessel-congestion', 'custom_fields': None, 'finding_normal_text': 'The pulmonary vessels are normal in appearance. ', 'finding_abnormal_text': 'The pulmonary vessels appear congested. '}, {'id': 2275, 'group': 'musculoskeletal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'soft-tissue-swelling', 'custom_fields': {'___s1_': ['the ventral', 'abdomen']}, 'finding_normal_text': 'There is no soft tissue swelling. ', 'finding_abnormal_text': 'There is soft tissue swelling involving ___s1_. '}, {'id': 2278, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'lung-fields', 'custom_fields': None, 'finding_normal_text': 'Lung fields are clear. ', 'finding_abnormal_text': 'cvp-cdp-bpp-tms'}, {'id': 2284, 'group': 'thorax', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'pleural-space', 'custom_fields': None, 'finding_normal_text': 'The pleural space is normal. ', 'finding_abnormal_text': 'There is evidence of pleural fluid and gas. '}, {'id': 2285, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'stomach-distension-find', 'custom_fields': None, 'finding_normal_text': 'The stomach appears empty. ', 'finding_abnormal_text': 'There is ___s1_ distension of the stomach with the presence of radiopaque material which has the appearance of ___s2_ . '}, {'id': 2295, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'kidney-margins', 'custom_fields': None, 'finding_normal_text': 'The visualized kidneys are within normal limits. ', 'finding_abnormal_text': 'rmn, rmg, skd'}, {'id': 2296, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'urolithiasis', 'custom_fields': None, 'finding_normal_text': 'No evidence of urolithiasis. ', 'finding_abnormal_text': 'urolithiasis'}, {'id': 2297, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'spine', 'custom_fields': None, 'finding_normal_text': 'The spine is radiographically normal. ', 'finding_abnormal_text': 'cid, tid, spn, van'}, {'id': 2298, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'intervertebral-disc-space', 'custom_fields': None, 'finding_normal_text': 'No significant intervertebral disc space narrowing is identified. ', 'finding_abnormal_text': 'There is intervertebral disc space narrowing at ___s1_. '}, {'id': 2299, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'degenerative-joint-disease', 'custom_fields': None, 'finding_normal_text': 'There is no evidence of degenerative joint disease. ', 'finding_abnormal_text': 'There is evidence of degenerative joint disease. '}, {'id': 2300, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'coxofemoral-pelvis', 'custom_fields': None, 'finding_normal_text': 'The coxofemoral joints and pelvis are unremarkable. ', 'finding_abnormal_text': 'hoa, hlx, pfx, not hic'}, {'id': 2500, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'fluid-wispy', 'custom_fields': None, 'finding_normal_text': 'Normal Wispy Fluid', 'finding_abnormal_text': 'There is a wispy soft tissue opacity noted over the ___s1_ in the ___s2_ abdomen.'}, {'id': 2562, 'group': 'abdomen', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '3', 'custom_text': None, 'signal_name': 'splenic-mass', 'custom_fields': None, 'finding_normal_text': 'Splenic mass', 'finding_abnormal_text': 'There appears to be a mass associated with the spleen. '}, {'id': 2580, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'Implant Motion/Infection', 'custom_fields': None, 'finding_normal_text': 'No evidence of implant motion/failure or infection identified.', 'finding_abnormal_text': 'An area of lucency associated with the implant is noted ____. '}, {'id': 2600, 'group': 'musculoskeletal', 'source': 'rules', 'history': False, 'attention': False, 'confidence': '-3', 'custom_text': None, 'signal_name': 'Vertebral Subluxation', 'custom_fields': None, 'finding_normal_text': 'No evidence of vertebral subluxation is identified.', 'finding_abnormal_text': 'Vertebral subluxation is noted at ____. '}], 'diagnosis': [{'id': 1541, 'state': 'abnormal', 'source': 'ai', 'history': False, 'attention': False, 'confidence': 100, 'diagnosis_name': 'Patellar luxation'}, {'id': 1542, 'state': 'abnormal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 100, 'diagnosis_name': 'Patellar luxation - lateral'}, {'id': 2666, 'state': 'abnormal', 'source': 'labelling', 'history': False, 'attention': False, 'confidence': 100, 'diagnosis_name': 'edema-soft-tissue'}], 'questions': [{'id': 2671, 'source': 'ai', 'attention': False, 'signal_name': 'neoplasia-abdomen'}, {'id': 2673, 'source': 'ai', 'attention': False, 'signal_name': 'neoplasia-musculoskeletal'}, {'id': 2676, 'source': 'labelling', 'attention': True, 'signal_name': 'lameness-general'}, {'id': 2678, 'source': 'labelling', 'attention': True, 'signal_name': 'lameness-hindLimb'}, {'id': 2684, 'source': 'labelling', 'attention': True, 'signal_name': 'screening-abdomen'}], 'recommendations': [], 'report_findings': 'Thorax\nThe observed thorax is within normal limits. No abnormalities are noted in the thorax.\n\nAbdomen\nThe spleen is mildly enlarged and there is an associated mass on the ventral surface. No other abnormalities are noted in the abdomen.\n\nMusculoskeletal system\nThere is gas present in the soft tissue of the ventral abdominal wall, accompanied by soft tissue swelling in the same area. No other abnormalities are observed in the musculoskeletal structures examined.', 'additionalSignals': [{'id': 6, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pleural-effusion', 'is_locked_out': True}, {'id': 7, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pneumothorax', 'is_locked_out': True}, {'id': 9, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spondylosis-spondylosis', 'is_locked_out': True}, {'id': 10, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-joint-effusion', 'is_locked_out': False}, {'id': 11, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bladder-bladder-stone', 'is_locked_out': True}, {'id': 12, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-distention', 'is_locked_out': True}, {'id': 13, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-dilatation', 'is_locked_out': True}, {'id': 14, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-foreign-body', 'is_locked_out': True}, {'id': 15, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-obstruction', 'is_locked_out': True}, {'id': 16, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-pelvis-fracture', 'is_locked_out': True}, {'id': 17, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-limb-fracture', 'is_locked_out': True}, {'id': 19, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'shoulder-arthropathy', 'is_locked_out': False}, {'id': 20, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'liver-hepatomegaly', 'is_locked_out': True}, {'id': 699, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'kidney-mineralization', 'is_locked_out': True}, {'id': 700, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'vert-cervical-narrowing', 'is_locked_out': False}, {'id': 701, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-lumbar-narrowing', 'is_locked_out': True}, {'id': 702, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 3, 'signal_name': 'spleen-splenomegaly', 'is_locked_out': True}, {'id': 708, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'urethra-calculi', 'is_locked_out': False}, {'id': 712, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-cranioventral-parenchymal', 'is_locked_out': True}, {'id': 713, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-caudodorsal-parenchymal', 'is_locked_out': True}, {'id': 715, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-pulmonary-pattern', 'is_locked_out': True}, {'id': 723, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-lesion', 'is_locked_out': True}, {'id': 733, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-foreign-body', 'is_locked_out': True}, {'id': 738, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'intestines-small-fm-foreign-material', 'is_locked_out': True}, {'id': 762, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'elbow-osteophytosis', 'is_locked_out': False}, {'id': 764, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'knee-osteophytosis', 'is_locked_out': False}, {'id': 783, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'right-heart-enlargement', 'is_locked_out': False}, {'id': 787, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tracheal-narrowing', 'is_locked_out': False}, {'id': 790, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-luxation', 'is_locked_out': True}, {'id': 797, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'kidney-renomegaly', 'is_locked_out': True}, {'id': 798, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'kidney-small', 'is_locked_out': True}, {'id': 799, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'esophagus-distension', 'is_locked_out': True}, {'id': 870, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'tarsal-metatarsal-osteophytosis', 'is_locked_out': False}, {'id': 871, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-gas', 'is_locked_out': True}, {'id': 873, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bronchiectasis', 'is_locked_out': True}, {'id': 879, 'source': 'labelling', 'history': False, 'attention': True, 'confidence': 2, 'signal_name': 'subcutaneous-gas', 'is_locked_out': True}, {'id': 880, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'general-cardiomegaly', 'is_locked_out': True}, {'id': 947, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'heart-vhs', 'is_locked_out': True}, {'id': 1605, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'stomach-n-gastric-material', 'is_locked_out': True}, {'id': 1932, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-mass-effect', 'is_locked_out': True}, {'id': 1933, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'peritoneal-limited-detail', 'is_locked_out': True}, {'id': 2141, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-thoracic-mass', 'is_locked_out': True}, {'id': 2158, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'vert-anomaly-class', 'is_locked_out': True}, {'id': 2159, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fracture-rib-fracture', 'is_locked_out': True}, {'id': 2160, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lung-diaphragmatic-hernia', 'is_locked_out': True}, {'id': 2166, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'heart-left-atrial-enlarge', 'is_locked_out': True}, {'id': 2215, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 2, 'signal_name': 'body-score', 'is_locked_out': True}, {'id': 2230, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-subluxation', 'is_locked_out': True}, {'id': 2231, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hip-neck-thicking', 'is_locked_out': True}, {'id': 2252, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'patellar-luxation', 'is_locked_out': False}, {'id': 2255, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'pulmonary-vessel-congestion', 'is_locked_out': False}, {'id': 2259, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'redundant-tracheal-membrane', 'is_locked_out': False}, {'id': 2262, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'small-liver', 'is_locked_out': False}, {'id': 2263, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'liver-mineralization', 'is_locked_out': False}, {'id': 2266, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'axial-fracture', 'is_locked_out': False}, {'id': 2267, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'distal-extremity-arthritis', 'is_locked_out': False}, {'id': 2268, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'subcutaneous-mass', 'is_locked_out': False}, {'id': 2271, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-luxation', 'is_locked_out': False}, {'id': 2272, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'muscle-atrophy', 'is_locked_out': False}, {'id': 2275, 'source': 'labelling', 'history': False, 'attention': True, 'confidence': 2, 'signal_name': 'soft-tissue-swelling', 'is_locked_out': False}, {'id': 2301, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'osteochondritis-dissecans', 'is_locked_out': False}, {'id': 2302, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'ununited-anconeal-process', 'is_locked_out': False}, {'id': 2303, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'hypertrophic-osteodystrophy', 'is_locked_out': False}, {'id': 2304, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'panosteitis', 'is_locked_out': False}, {'id': 2313, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'craniomandibular-osteopathy', 'is_locked_out': False}, {'id': 2363, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'mediastinal-gas-c', 'is_locked_out': False}, {'id': 2364, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fragmented-medial-coronoid', 'is_locked_out': False}, {'id': 2375, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'angular-limb-deformity', 'is_locked_out': False}, {'id': 2384, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'surgical-device', 'is_locked_out': False}, {'id': 2402, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'mineralized-disk', 'is_locked_out': False}, {'id': 2412, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-mineralization', 'is_locked_out': False}, {'id': 2414, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'caudal-vena-cana-sm', 'is_locked_out': False}, {'id': 2415, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'microcardia', 'is_locked_out': False}, {'id': 2417, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'enthesopathy', 'is_locked_out': False}, {'id': 2418, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lumbosacral-degeneration', 'is_locked_out': False}, {'id': 2419, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'lymphadenomegaly-c', 'is_locked_out': False}, {'id': 2423, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'liver-mineralization-gb', 'is_locked_out': False}, {'id': 2446, 'source': 'ray', 'history': False, 'attention': False, 'confidence': 0, 'signal_name': 'carpal-metacarpal-osteophytosis', 'is_locked_out': False}, {'id': 2498, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Lumbosacral-stenosis', 'is_locked_out': False}, {'id': 2500, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'fluid-wispy', 'is_locked_out': False}, {'id': 2561, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'irregular-splenic-margins', 'is_locked_out': False}, {'id': 2562, 'source': 'labelling', 'history': False, 'attention': True, 'confidence': 2, 'signal_name': 'splenic-mass', 'is_locked_out': False}, {'id': 2566, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Subcutaneous foreign body', 'is_locked_out': False}, {'id': 2573, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Tibia Displacement', 'is_locked_out': False}, {'id': 2579, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Tortuous vessels', 'is_locked_out': False}, {'id': 2580, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Implant Motion/Infection', 'is_locked_out': False}, {'id': 2600, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Vertebral Subluxation', 'is_locked_out': False}, {'id': 2617, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'joint-effusion', 'is_locked_out': False}, {'id': 2637, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Distal fabella displacement', 'is_locked_out': False}, {'id': 2641, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spondylosis-dish', 'is_locked_out': True}, {'id': 2642, 'source': 'ray', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'spondylosis-bridging', 'is_locked_out': True}, {'id': 2645, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'agressive-bone-lesion-discospondylitis', 'is_locked_out': False}, {'id': 2653, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Fragmented-fabella', 'is_locked_out': False}, {'id': 2666, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': "Hypertrophic osteopathy (Marie's disease)", 'is_locked_out': False}, {'id': 2667, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'bone-lesion-spine', 'is_locked_out': False}, {'id': 2714, 'source': 'labelling', 'history': False, 'attention': False, 'confidence': -3, 'signal_name': 'Gall bladder emphysema', 'is_locked_out': False}], 'report_conclusions': 'Conclusions:\nSubcutaneous gas and soft tissue swelling consistent with penetrating soft tissue trauma. No pathology observed in the underlying bony structures.\nLimited evaluation of the right hindlimb and both patellae due to positioning (one the lateral images) and partial limb images on the VD view.\nThe changes noted in the spleen are consistent with a splenic mass. Both benign (hemangioma, abscess, other) and malignant (hemangiosarcoma, lymphoma, other) etiologies are possible.\n\nRecommendations:\nMedical management as required for soft tissue injury is indicated.\nDue to limited evaluation, consider additional radiographic views or advanced imaging if a more thorough evaluation is needed.\nConsider abdominal ultrasound and/or exploratory laparotomy for further investigation to determine the nature of the splenic mass identified. \nCheck coagulation profile before any invasive procedures are performed.'}

{'bday': '2014-07-12', 'name': 'Shavet^Sophie', 'breed': 'Mixed', 'owner': 'Shavet^Malinda', 'gender': 'F', 'weight': '', 'species': 'Canine', 'neutered': 'ALTERED', 'species_other': ''}

{'name': 'Emergency Pet Care of Texas', 'email': '[email protected]', 'address': 'United States - Magnolia', 'clinician': 'Emergency Pet Care of Texas'}

Sophie presented today for acute lameness on right hind leg. The owner reports that this evening, patient may have fallen off the couch and injured leg. Owner also reports that she tripped over patient this morning and patient cried out during episode but seems OK afterwards. Severe bruising and cellulitis on caudoventral abdomen extending into inguinal area and medial aspect of right hind leg. RPL has pitting edema present. Bilateral 4/4 luxating patellas

-Bilateral 4/4 luxating patellas. -Weight bearing lameness right hind leg. -bruising/cellulitis - spider bite? -Right hind leg has pitting edema -Splenic mass

standard

['neoplasia-abdomen', 'neoplasia-musculoskeletal', 'lameness-general', 'lameness-hindLimb', 'screening-abdomen']

['Bruising/contusion', 'Mass/swelling - abdomen', 'Whining/whimpering/groaning', 'Bleeding - hematoma', 'Mass/swelling - limb', 'Lameness', 'Hindlimb lameness', 'Edema', 'Fell/dropped', 'Canine Medium/Large Breed']

[]

[54, 141, 292, 550, 575, 2185, 2345, 2474, 2530, 2656]

[]

['Patellar luxation', 'Patellar luxation - lateral', 'Edema, soft tissue']

[]

[1541, 1542, 2666]

[]

[]

[]

[]

[]

"{'patient': {'bday': '2023-11-08', 'name': 'Griffin^Guiness', 'breed': 'Domestic Shorthair', 'owner(...TRUNCATED)

"{'tags': {'userTags': [], 'difficulty': 'standard', 'consults_mode': 'text', 'findings_mode': 'code(...TRUNCATED)

"{'bday': '2023-11-08', 'name': 'Griffin^Guiness', 'breed': 'Domestic Shorthair', 'owner': 'Griffin^(...TRUNCATED)

"{'name': 'Animal Urgent Care Tri-State', 'email': '[email protected]', 'address': 'United States -(...TRUNCATED)

"Clients returned home and found P to be lethargic, and 5-6 vomit piles around the house (mostly bil(...TRUNCATED)

Looking for evidence of foreign body vs. poss. significant worm burden.

standard

['Vomiting-FB/obstruction', 'Gi signs - Systemic vs general']

"['Diarrhea', 'Lethargic/tired', 'Vomiting', 'Hematemesis (vomiting blood)', 'Worm infestation', 'Ab(...TRUNCATED)

[]

[76, 131, 256, 282, 295, 508, 622, 2327, 2359]

[]

[]

[]

[]

[]

[]

[]

[]

[]

"{'patient': {'bday': '2024-04-19', 'name': 'ALEGRIA^LUKA', 'breed': 'Weimaraner', 'owner': 'Ronnie (...TRUNCATED)

"{'tags': {'userTags': ['basic_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findings(...TRUNCATED)

"{'bday': '2024-04-19', 'name': 'ALEGRIA^LUKA', 'breed': 'Weimaraner', 'owner': 'Ronnie Alegria ', '(...TRUNCATED)

"{'name': 'Burleson Animal Emergency Hospital', 'email': '[email protected]', 'address': 'U(...TRUNCATED)

"patient presents for +/- foreign body, owner reports that p stopped eating Saturday night and has n(...TRUNCATED)

+/- foreign body

standard

['Vomiting-FB/obstruction']

"['Lethargic/tired', 'Vomiting', 'Hyporexia', 'Suspected foreign body ingestion', 'Canine Medium/Lar(...TRUNCATED)

[]

[131, 256, 607, 2184, 2656]

[]

[]

[]

[]

[]

[]

[]

[]

[]

"{'patient': {'bday': '2014-06-14', 'name': 'Diaz^Lilah', 'breed': 'Chihuahua', 'owner': 'Rosangela (...TRUNCATED)

"{'tags': {'userTags': ['standard_level'], 'difficulty': 'standard', 'consults_mode': 'text', 'findi(...TRUNCATED)

"{'bday': '2014-06-14', 'name': 'Diaz^Lilah', 'breed': 'Chihuahua', 'owner': 'Rosangela ', 'gender':(...TRUNCATED)

"{'name': 'EVS Urgent Care Kissimmee', 'email': '[email protected]', 'address': 'United States - Kiss(...TRUNCATED)

"Lilah presents for walking around hunched \r\nO states P seems to be in pain in the abdominal area (...TRUNCATED)

Cause of pain, Abdominal vs Spinal

standard

['spine-neurological-ivdd-pain', 'non-specific-ADR']

['Hunched up', 'Lethargic/tired', 'Hyporexia', 'Pain - abdominal', 'Pain', 'Canine Small Breed']

[]

[121, 131, 607, 622, 2186, 2654]

[]

[]

[]

[]

[]

[]

[]

[]

[]