C09976393 / invoice 10000

Reason: Ghc Second Opinion ApAppointment Notes: - ap called o to get priovios vet no answer ap @10.20am- o called back ap called southcost @10.30am will send hx over ap- 11.40am hx attached apPrior Hx:- Long Hx of chronic diarr/vomiting on/off. Prior abdo US 7/2025. BloodsGas in stomach and colon and filled with faeces, perhaps a mildly inflammed pancreas and the stomachhas either something in it or the gas is obscuring a proper view. Was in hosp for 2d. Prior hills sensitive stomach, put onto Diet trial with hills z/d +/- prime100 novel proteinHistory:- Main concern: O worried about HM, wanting 2nd opinion- Vomiting and diarrhoea: long history of intermittent episodes. Recent yellow vomit few days ago before breakfast, sometimes occurs in afternoon. Last episode few days prior to visit. But improved since starting z/d. History of coprophagia. O happy to monitor this at the moment- 2d ago recently stopped prokolin.- EDUD normally otherwise. No current meds. No other concernsExam:Behaviour: friendlyMentation: BAROral Exam: Mild/mod calculus DG: 1.5/4, MMs: pink, moist, CRT<2Ears: WNLEyes: Bilaterally mild cloudiness to lensCardioresp auscultation: HM very slight, gr 1-2. Poss mild sinus arrythmia, HR: 120, RR: 28, lung fields WNLGI: abdo palp WNL, soft and comfortableUrogenital: WNLSkin: WNLLymph nodes: WNLMusculoskeletal: WNL, mild HL muscle wastageNeuro: WNLAssessment:- Grade 1-2 heart murmur detected. - Possible early cataracts or age-related ocular changes noted. - Mild DJD + dental diseaseTreatment:Owner has consented to treatment: yesPlan:- Heart murmur: echocardiogram offered, referral details to be emailed. Home monitoring of resting respiratory rate recommended. Discussed pathogenesis/meaning of HM etc of heart diease. O understanding.- Diet trial: continue ZD dry food only for 8 weeks- Arthritis: injectable medications discussed, O will monitor for now- Dental disease: noted, any future dental procedures recommend echo prior- Weight management: monitor, target weight 5.5-5.8kg--- 02/03/2026 14:54:12 GMN:In regards to Ralph for a referral for an echocardiogram:- The Austin Veterinary Specialists: Outpatient echocardiogram approximately $700-800 inclusive of sedation if required.- SASH (Small animal specialist hospital): Echocardiogram package (inclusive of internal medicine consultation, echocardiogram, blood pressure, sedation, ECG monitoring) approximately $1200-1300.Please let us know if you would like a referral for these clinics, we will then send our history to them for you to be contacted. Kind regards, Dr. Geneve Manning, Greencross Vets Noarlunga.    Vital Signs    Weight: 5.9;