C09976930 / invoice 10000

Peaches.Reason:Recheck and show how to give B12 injections.History:Was found to have IBD and hypocobalaminemia some time ago. Recommended supplementation but Shyla has been quite unwell and has not been able to come in for a while.Has been reasonably well at home. Eating well, normal defecation. Normal energy levels.No V+, no D+, no coughing, no sneezing.Is UTD with flea treatment.Examine:BAR, mentation appropriate.HR: 200, no murmur or arrhythmia. RE: WNL, RR: 40No fleas/flea dirt. Good skin and haircoat. Clean and clear and without lesions.Normal muscling and PROM in all limbs.T: 38.2Abdo soft and comfy. Small soft bladder. Normal faeces present in colon.External genitalia/perineum normal.BW: 3.75kg - is still 4/9 BCS but has not lost any further weight.Assessment:Start B12 injections.Fairly stable IBD on prednisolone and diet.Plan:Continue B12 injections - 0.25mls SC weekly for 6 weeks, then again one month later.    Vital Signs    Weight: 3.75;