C09976556 / invoice 10000

Reason: Qol Discuss And Ionised Calcium Blood TestAppointment Notes: BC looked up protocol- advised client to fast from 8pm night before and test is sent away.Booked as a consult as wants to make fairy meadow gx their reg vet and to start making plan for when time comes for euthSubjective: Owner reports on ondansetron and able to handfeed chicken and yoghurt though appetite is poor; struggles to get up and unable to walk far nowObjective: Coat and skin: appear normalEyes: appear normalEars: appear normalNose and throat: appear normalMouth, teeth and gums: Appear normalLegs and paws: appear normalGait: slowHeart: Normal on auscultationLungs: Normal on auscultationAbdomen: Tense esp caudal sectionLaboratory:Assesment: Anal sac adenocarcinomaAbdominal Lymphadenopathy - inflammatory on FNAInappetant Painful abdomenPoss AV block, tachyarrhythmiaPlan:Brought in by male owner - have opted for palliation, declined admission and further work fluid TxInj Tem 2ml IM/SCDisp paracetamol and gabapentinIf insufficient can consider adding Tramadol or Bupe TMConsidering home euth    Vital Signs    Weight: 32;       HeartRate: 60;       RespirationRate: 36;       CRT: 2 secs;       MMColour: pale pink;       Temperature: 40;       BodyScore: 2.5/5;