C09974870 / invoice 10000

advise blood is okto monitorotherwise responded well with apoquelto call back if there is any issue

ASAP NATA Accreditation Number: 20149OwnerAnimal IDClinic Ref  ArmsteadMaxE1754091021 Ringwood East Vetcare106 Railway AveRingwood East VICRingwood East VetcareSpecies, BreedAge, SexMicrochip, PICCanineMiniature Schnauzer4 YearsMale Case signed off by Sonia McLean Laboratory ScientistHaematologyResults Verified on 04/08/2025 by fyTestResultRef IntervalMeterTestResultRef IntervalMeterRCC x 1012/L7.81  5.46 - 8.39|----*|WC Count x 109/L10.9  5.3 - 14.9|--*--|Hct L/L0.56 *0.37 - 0.55|-----|*Neutr %76  Hgb g/L199  130 - 200|----*|Seg Neut x 109/L8.3  3.1 - 10.3|---*-|MCV fl72  61 - 77|---*-|Band %4  MCH pg26  21 - 26|-----*Band Neu x 109/L0.4 *0 - 0.2|-----|*MCHC g/L356  324 - 363|----*|Lymph %14      Lymph x 109/L1.5  0.9 - 4.1|*----|Platelet x 109/L336  200 - 500|--*--|Mono %6  retic %0.41  0.2 - 1.5|*----|Monocyte x 109/L0.7  0.2 - 1.0|---*-|Retic x 1012/L0.03  0.01 - 0.09|-*---|Eosin %0  ret-He pg24.4  21.3 - 28.1|--*--|Eosin. x 109/L0.0  0 - 1.3|*----|nRBC %0.3  Baso %0      Basophil x 109/L0.0  0 - 0.1|*----|* Blood Smear Exam -**:Mild smudging of RBC'sWhite blood cells normal in morphology.Platelets are clumped and within normal limits. BiochemistryResults Verified on 04/08/2025 by smTestResultRef IntervalMeterTestResultRef IntervalMeterTot Prot g/L70  53 - 73|----*|Urea mmol/L6.5  3.3 - 9.2|--*--|Alb g/L37  27 - 38|----*|Creat umol/L77  39 - 117|--*--|Glob g/L33  23 - 38|---*-|Tbili umol/L1 *0 - 4|-*---|Bicarb mmol/L22  17 - 26|--*--|ALT IU/L24  13 - 98|*----|Glucose mmol/L5.2  3.4 - 6.7|--*--|AST IU/L33  17 - 84|-*---|Na mmol/L152  142 - 154|----*|ALP IU/L35  0 - 182|*----|K mmol/L5.1  4.0 - 5.8|---*-|CK IU/L306.4  73 - 522|--*--|Cl mmol/L109  103 - 116|--*--|Chol mmol/L7.7  3.3 - 10.0|---*-|Na:K30  25 - ... Trig mmol/L1.6  0.2 - 1.7|----*|An. gap mmol/L26  12 - 26|-----*Amylase IU/L650  334 - 1277|-*---|Ca mmol/L1.9  1.7 - 2.7|*----|Lipase IU/L26  0 - 75|-*---|Phos mmol/L1.7  0.8 - 1.9|----*|EndocrinologyResults Verified on 04/08/2025 by smTestResultRef IntervalMeterTestResultRef IntervalMeterTot T4 nmol/L28  13 - 47|--*--|**:INTERPRETATION GUIDELINES FOR TOTAL T4 IN DOGS:NORMAL TT4: Usually excludes hypothyroidism. In rare cases auto-antibodies against TT4 can positively interfere with the assay. Only very rarely will hypothyroid dogs have T4 concentrations that are within the low end of the reference interval. In this situation, only if  clinical signs are highly suggestive of hypothyroidism may further diagnostic options be considered such as an endogenous cTSH and free T4 by equilibrium dialysis (ED).LOW TT4 : In isolation is not diagnostic for hypothyroidism. Low values are commonly a consequence of non- thyroidal illness (euthyroid sick syndrome), including with other endocrinopathies. Low TT4 may also be seen in dogs receiving drug therapies (e.g. corticosteroids, phenobarbitone, NSAIDs), or could be breed-related (e.g. Greyhounds, other sight hounds, Basenji's).If clinical signs are suggestive of hypothyroidism, further diagnostic options include endogenous cTSH and free T4 by ED.INCREASED TT4: Explanations include: a normal variation (especially if the dog is clinically normal), a functional thyroid neoplasm (uncommon), auto- antibodies interfering with the TT4 assay (rare, a Free T4 by ED is of value to resolve thyroid status in these cases), ingestion of a raw meat diet containing thyroid tissue and supplementation with thyroxine.REPLACEMENT THERAPY TARGET VALUES:Peak TT4 (collected 4-6 hours after thyroxine administration): 35 - 70 nmol/LDose alterations should not be based on TT4 alone but should also include consideration of clinical progress.CodeDescription622Canine Wellness Profile

H:has been licking the feet. otherwise edduf. no v or d.Exam:MM:PPCRT:<2dental: grade 1Nose:wnlLN:wnlEars:wnlEyes:wnlThoraxsounds ok. pantingAbdomen:pot bellied?Integ:erythema on all four feet. skin tape: yeastMsk:wnlNeuro:wnlReprownlPer rectumwnlAssessmentpossible Cushing? allergyPlan:to use apoquel 5.4mg 1 tab sid as needed 15 tabsto use neocort and malaseb combo packto take blood to check for possible Cushingto call back if there is any issue