C09971138 / invoice 10000

02/03/2026 Consultation nurse: AH 

Reason for presentation: recheck 

History for today:
maintaining statues, no assistance up the stairs. 
good appetite, with swirls. 
energy levels varies. 
incontinence still consistently bad. 
singular V+ just prior to O leaving for trip. 
O keen to monitor for now (no tests)  and reassess in 4 weeks. O keen to continue with AB as helping. 

Previous medical/surgical concerns:
13/2/26 - reinstated meloxicam at low dose, renal parameters fairly stable and observable improvement in demeanour/mobility
23/1/26 - suspected pyelonephritis (pyrexia, weakness, pyuria, azotemia) 
- 08/12/2025: Clinically stable/palliative, ocular discharge bilaterally R>L.
- 13/10/2025: Review of bladder and liver neoplasia. Minimal changes on U/S. Bloods showed increased ALP (11,000), ALT (900), SDMA 24, urea 34, creatinine normal.
- Aug 2025: Liver mass, bladder neoplasia, renal disease, elevated liver enzymes.
- Chronic liver disease/hepatic abscesses.
- Heart murmur.
- OE.
- Lymphoma treated with chemotherapy in 2021.
- Ex-lap for jejunal foreign body in 2023.

Current medications:
meloxicam 0.3ml sid
clavulox 125mg bid
sam-E
chlorambucil 2mg eod

Microchip (scan & record): on file 
Client email (add to file):on file 

Diet:

Examination:
BAR 
R eye clean and not inflamed today
ears hairy but not inflamed
LNs normal
mm pink crt <2. 
ds 2
HR 100, g 2-3 murmur, reg rhythm
rr 20
abdomen tense
bcs 5/9, gained a little condition
healthy coat


Assessment:
stable and clinically very well!

Treatment:
will continue on antibiotics for now, especially since owner will be going away again shortly - do not want to risk pyelonephritis again
continue all other meds as is

Next vaccination due: 

Plan: 
recheck in a month