C09973652 / invoice 10000

Reason: KW Chemo Again Appointment Notes: Doxo week10 + Staging with Bicavitary CTHistory: Presenting for week 10 doxorubicin for stage III splenic HSA. - O notes no V+ after previous treatment, D+ is better than last time but "not perfect"- O feels that tremoring has reduced since last time.- Verbal consent obtained for bicavitary CT today.O notes pregabalin dosage to be heavy - causes him to be extremely drowsy Current Medications: 1) Pregabalin 150mg (Pregabalin 150mg, 1 tab) PO bid 2) Bedinvetmab (Beransa) SQ q1mth - for OA/DJD 3) Diet = Hill's J/D, Lyka 4) Nutraceuticals = Antinol PO sid Examination:Wt 28.7kg BAR, MM pink, CRT 1s, HR 140 PR strong and synch, RR panting, normal Resp effort, Temp 38.8Arthritic gait Coat looks thinner than previously, bald patches on areas of rubbing/pressureLaboratory: HCT 34.5% (37.3 - 61.7) Neu 9.87 x10^9/L PLT 602 K/µL (148 - 484) CREA 72 µmol/L Problem List: 1) Chronic OA/DJD - CHD confirmed RAD as puppy - on Beransa, Metacam, Antinol, J/D 2) Hx STS grade 2 - excised right elbow 20/11/2023 with margins 3) Hx STS grade 2 ventral abdominal skin 9/4/2025 with margins 4) Chronic intermittent cough 5) Arrhythmia - no ECG 28/5/2025, 23/6/2025 - not present 21/7/2025, 26/8/2025 6) Stage III Splenic HSA (28/11/25) - CT 28/11/25 = Multiple splenic nodules; Multiple hepatic nodules; cystic hyperplasia of the hepatic, pancreaticoduodenal and sternal lymph nodes; Small solid nodules (x2) in the right cranial/middle lung lobes; Multiple gas cavitated lesions in the right caudal lung - Splenic histopathology 28/11/25 = Splenic haemangiosarcoma; Splenic benign nodular hyperplasia; Splenic parenchymal congestion and mild marginal zone hyperplasia; Liver = Multifocal haemangiosarcoma; generalised centrilobular lipofuscinosis 7) Gastric cloth foreign body (28/11/25) - Rx with Gastrotomy 8) Cystoliths (28/11/25) 9) IRIS Stage I CKD (28/11/25) - CT = Small degenerative renal cysts; Creatinine, Urea and SDMA 28/11/25 within normal limits Assessment: Fit for chemotherapy. Given torb 0.2mg/kg IV and 0.02mg/kg midaz IV sedation for CTTreatment: Week 10 Wt 28.7kg = 0.947 m2 BSA Doxorubicin 30 mg/m2 = 30 x 0.947 = 28.41 mg = 14.2 ml (2 mg/ml) IV Dexamethasone 0.1 mg/kg IV (2mg/ml) = 1.44 ml IV Chlorpheniramine 0.25 mg/kg sc (10mg/ml) = 0.7 ml sc Maropitant 1 mg/kg IV (10mg/ml) = 2.87 ml IVHome with (O requested all meds as has run out): Maropitant 40 mg PO SID 3 days Metronidazole 250 mg PO BID 5 days Pregabalin 150mg PO BIDPlan: Back in 3 weeks for Week 13 > CBC, Biochem, DoxoOwner communication:- O consented to CT today and requested medications and a nail trim    Vital Signs