C09977892 / invoice 10000

Reason: Recheck +/- Re-AdmitAppointment Notes: --- 03/03/2026 08:30:57 SHA:SH called & spoke with Ashlie for a follow up on Nala.O mentioned she didn't have a great night, as Nala was up most of it. She was able to give Nala the Cerenia tablet around 1am. Nala seemed unsettled, didn't want to get up, growled when O touched her, and still wasn't interested in eating. O is dropping her kids off at school and will try to bring Nala in for the 9:20am appointment. If that time doesn't work, O has been advised to call us so we can find another time that works better for her.History:- Re-presentation following treatment on 02/03/2026 for pain management secondary to metastatic osteosarcoma cancer.- Condition has deteriorated. Now non-weight bearing on a hind limb, which was not present yesterday.- Anorexia for over 48 hours. Refusing all food.- Owner administered Paracetamol and two other prescribed medications at 02:00 this morning with difficulty.- Was reportedly crying last night.- Presented to SASH on Thursday (28/02/2026) where pain medication was initiated. Initially improved, was eating and playing, but declined from yesterday morning (02/03/2026).- SASH report indicates spinal metastases.Assessment:- Worsening pain and neurological deficits, likely due to progression of spinal metastases.- Poor response to previous day's pain relief infusions.- Quality of life severely compromised.Plan:- Discussed prognosis and further treatment options with owner. Options included more aggressive pain relief via infusions or humane euthanasia.- The owner has elected for humane euthanasia due to poor prognosis and progression of clinical signs.- Euthanasia to be performed later today to allow family members to be present.- Cremation organised as per owner's request.Client communication:- Discussed the aggressive nature of the cancer and the likelihood that the worsening signs are due to progression of spinal metastases, potentially compressing a nerve.- Confirmed the owner's understanding that euthanasia is a kind and appropriate decision in this circumstance given the advanced nature of the disease and poor quality of life.- Arranged for Nala to be kept comfortable at the clinic until the owner and family return for the procedure. Instructed owner to call when they are on their way.--- 03/03/2026 1030amMethadone 1.2mL IV for analgesia while we wait for Ashlie to returnEuthanasia:0.5mL ACP IV20ml letharbabrb IVSmooth euthAsystole confirmedPrivate creamtion    Vital Signs