C09974503 / invoice 10000

Things not going well with Pumpkin. Mobility is really bad. O stopped Beransa because of bad publicity. Didn't have any adverse effects but was worried. Went to Bloomin' vets, did a course of zydax, then monthly during winter, then 2-monthly during summer. O said she went downhill getting off the Beransa. So started meloxicam, was OK for a bit, but then had GI issues. Recc to do gabapentin and panadol but didn't help. Needed to be carried. Galliprant was making her unsettled. Panadol helped maybe a little bit. Then O went to the rehab place (2 weeks ago) to do redlight and shockwave therapy, but doesn't think it helped and person recc going back on meloxicam but it caused bleeding again. O then went to AES on Wednesday who recc Tramadol. O thinks it's helping a bit as she can walk but she's not herself anymore.No vomiting or diarrhoeaPoos return to solids, which hasn't been for months.Stopped cardisure around Dec 2025 because of D+. O hasn't been counting RRR.Dosage: 665mg Pandol TID (24.6mg/kg)History: Balanced Rehab - said the bloods were OK, Bloomin's VetAESExamination:HR 120bpm, G5/6 heart murmur. Arrhythmias present (unable to diagnose what type)RR pant, both lung fields sound clearMM pink, CRT <2sT not takenMSK: severe crepitus of stifles, severe reduced ROM in both hips. Plan:- Discussed trialling diff NSAIDS (previcox, galliprant). O hesitant due to bad SE with meloxicam- Discussed trialling Beransa again. Went through pros and cons O agreed- Beransa 15mg given SQ (0.55mg/kg). Monitor response. If effective but increased frequency, then can increase to 20mg or 30mg (up to 1mg/kg dose)- Continue on gaba, tramadol and panadol- 400mg gabapentin dispensed - To give 400mg TID Consider trialling amantadine - diff NDMA receptor drugConsider CBD oil    Vital Signs