The task
Assume that today's date is 22 October 2026. Ollie is being discharged home this afternoon.
You are the veterinarian at a small-animal general practice. Using the information in the case notes, write a letter to Dr Karthik Mirza, a small-animal soft tissue surgeon, referring Ollie for assessment for perineal urethrostomy. Address the letter to Dr Karthik Mirza, Small Animal Soft Tissue Surgeon, Specialist Surgery Department, 220 Riverside Drive. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Referral letter.
Case notes
Patient details
- Patient: Ollie, domestic shorthair (DSH), male neutered (MN)
- Age: 5 yrs; BCS 6/9
- Owner: Ms Sana Abbasi (contact details on file)
- Presented 19/10/26 (3rd episode); discharge 22/10/26
Social background
- Indoor only; lives in flat with owner + 2nd cat (F, 8 yrs); some tension between cats, separate food/water/litter provided
- Enjoys watching birds from balcony window
- Owner on limited budget; cannot afford further emergency admissions; requests written cost estimate before booking surgery
- Owner anxious re GA risk + post-op complications (stricture, incontinence); wants to know long-term outlook
- Owner's mother told her to 'just put him down if it happens again'
- Owner complained about long wait + high fees at after-hours emergency clinic (episode 2)
Medical history
- Vaccinations up to date; annual health check 03/26 NAD
- Dental scale & polish 2024
- Episode 1 (06/26): urethral obstruction; catheterised under GA, 3 days hosp; UA struvite crystalluria, culture neg
- Episode 2 (08/26): obstruction; managed at after-hours emergency clinic; indwelling catheter 2 days
- Since 06/26: prescription urinary diet (wet) exclusively; ↑ water intake (fountain, water added to food); stress mx — pheromone diffuser, extra litter trays, daily play
- Owner reports good compliance with diet + stress measures
- Allergies/adverse drug reactions: nil known
Current episode (19/10/26)
- Hx: straining in litter tray approx 12 hrs, vocalising, vomited x1
- O/E: large, firm, painful bladder; mildly depressed; mild dehydration
- Bloods: azotaemia + hyperkalaemia → normalised with IV fluids by 21/10
- Catheterised under GA; obstruction at distal (penile) urethra; mucus plug + sandy material flushed
- Indwelling urinary catheter 48 hrs; IV fluids, analgesia; post-obstructive diuresis managed
- UA: struvite crystals, haematuria; urine culture: no growth
- Abdo radiographs: no radiopaque uroliths in bladder/urethra; abdo US: thickened bladder wall, sediment, no uroliths
- Catheter removed 21/10; urinating voluntarily, normal stream, no straining since
Treatment on discharge
- Oromucosal buprenorphine x 3 days; continue urinary diet + stress measures
- Owner instructed to return immediately if straining or no urine passed
Plan
- Refer to soft tissue surgeon re perineal urethrostomy — 3 obstructions in 4/12 despite medical mx
- Owner requests consultation incl. cost estimate, risks + prognosis before deciding
- Ask surgeon whether contrast urethrography needed pre-op
- Copies of bloods, UA, culture + imaging to be sent with referral
- Recheck at practice 29/10 (UA, renal values) if surgery not yet scheduled
Who is reading, and what do they need?
Dr Mirza is a soft tissue surgeon who has not met Ollie. He needs the episode history, evidence that medical management has not prevented recurrence, current investigation findings, and what the owner wants from the consultation. He is an expert, so keep procedures brief and avoid explaining the surgery.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 3 obstructions in 4/12 despite medical management | This is the justification for referral and must be stated clearly at the start. |
| Episode 1 (06/26): catheterised under GA; struvite crystalluria, culture negative | Gives the first episode with its key findings, so the surgeon sees the pattern. |
| Episode 2 (08/26): after-hours clinic; indwelling catheter 2 days | Completes the history. Only the management and duration are needed. |
| Prescription wet urinary diet, water intake measures, stress management; good compliance reported | Shows what medical management has been tried. Say compliance is as the owner reports. |
| Obstruction at distal penile urethra; mucus plug and sandy material flushed | The key finding of the current episode, relevant to the urethrostomy decision. |
| Azotaemia and hyperkalaemia normalised with IV fluids by 21/10; catheter removed 21/10 | Records severity and recovery. The cat now passes urine voluntarily with a normal stream and no straining. |
| UA struvite crystals, haematuria; culture no growth; no uroliths on radiographs or US | Key investigation results, including the thickened bladder wall and sediment on ultrasound. Results are enclosed. |
| Owner wants consultation with cost estimate, risks, prognosis; ask re contrast urethrography | These are the requests and the question for the surgeon. Include the owner's concerns about GA, stricture and incontinence, and the 29/10 recheck. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Owner's mother said to 'just put him down if it happens again' | A relative's opinion, not the owner's decision, and not needed for assessment. |
| Owner complained about long wait and high fees at after-hours clinic | A complaint about another clinic. Her budget concern is covered by the request for a cost estimate. |
| Enjoys watching birds from balcony window | Trivial lifestyle detail with no bearing on the referral. |
| Dental scale & polish 2024; annual health check 03/26 NAD | Trap: it looks like routine history for a surgeon but is unrelated to the urinary problem. |
| Some tension between cats; separate food, water, litter | Only the stress management measures need mention. The detail of the cats' relationship can be left out. |
| Oromucosal buprenorphine x 3 days | Discharge analgesia is minor for a surgical referral. Mention only if briefly useful for current treatment. |
A paragraph plan for this case
State the purpose and the pattern of three obstructions in four months, then give the earlier episodes and the medical management tried. Next give the current episode, investigations and status at discharge, then the owner's requests, the question about contrast urethrography, the enclosures and the 29/10 recheck.
Where candidates slip on this task
- The owner wants information before deciding, including cost estimate, risks and prognosis. Word this as a request for a consultation covering these, not as a decision to proceed with surgery.
- Keep the dates and sequence right: episodes in 06/26, 08/26 and 19/10/26, catheter removed 21/10, discharge 22/10. Do not add a catheter duration beyond 48 hours for this episode.
- Present the diet and stress measures as the owner's reported compliance, and list imaging results exactly: no radiopaque uroliths on radiographs, no uroliths on ultrasound, thickened bladder wall and sediment.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Veterinary Science letter tasks
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- Grape ingestion treated at an out-of-hours emergency clinic update letter
- Discharge after colic surgery in a horse update letter
Your profession's guide: OET Veterinary Science. Layout and structure: OET letter format.
Questions about this task
Should the owner's budget be mentioned?
Only as it affects the request: she asked for a written cost estimate before booking surgery. Keep it factual and brief. Leave out her complaint about the after-hours clinic's fees and wait.
How do I handle the question about contrast urethrography?
Present it as a question to the surgeon about whether it is needed before the operation. Do not say it is required, and note that the existing radiographs and ultrasound found no uroliths.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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