C09979125 / invoice 10000

Reason: Paralysed Down Side Of BodyHistory:History of immune mediated disease 2017. Immune Mediated Panniculitis.Not on any medication.* 20-30 minutes before presentation, the owners said that Lulu was moving abnormally to her left side. She was leaning to the left. Improved by time of the consult. Lulu had previously been on the bed and had been asked to hop down.First episode.Has eaten last night and this morning.Diet: Lyka and kibble.Drinking OK.Urinating and defecating normally.On NexGard Spectra.* Had the area sprayed for pests about 2 weeks ago.Has not been to a paralysis tick area.Examine: QAR. Skin and ears OK. Grade 1/4 dental disease. Ears OK (though excessive hair in both external ear canals).OD enucleated.Thoracic auscultation normal limits. Peripheral lymph nodes normally sized. NAD on abdominal palpation. Good demeanour.NAD on spinal and neck palpation.NAD on HL palpation.Neurological exam:Gait exam: moved well in the consult room.Mentation: BAR.Posture: normal.Spinal Reflexes:WDR 4 limb +Patella reflexes L pelvic limb +, R pelvic limb +.Cutaneous trunci L and R not obvious to the lumbar regions.Propriception 4 limb +.Neck ROM NAD.Cranial Nerves:OS PLR +Gag reflex +Facial sensation L+, R+No nystagmus observed.Obtained blood from the left jugular vein for an Idexx In House Major Profile.Laboratory: Saline agglutination test negative.Idexx In House Major Profile:Haematology:RBC 5.21 (5.65-8.87) x 10^12/l (L)HCT 0.352 (0.373-0.617) l/l (L)% Retic. 5.0%Retic. 259.1 (10.0-110.0) K/ul (H)WBC 17.04 (5.05-16.76) x 10^9/l (H)Neut. 14.69 (2.95-11.64) x 10^9/l (H)Mono. 1.23 (0.16-1.12) x 10^9/l (H)Eos. 0.00 (0.00-0.10) x 10^9/l (L)PDW 20.4 (9.1-19.4) fl (H)MPV 14.0 (8.7-13.2) fl (H)Biochemistry:ALT 145 (10-125) U/l (H)Amylase 480 (500-1,500) U/l (L).Assessment:Regenerative anaemia. Ddx Immune-mediated disease, blood loss, other.Leucocytosis, neutrophilia, monocytosis.Increased ALT- mild hepatopathy.Episode of leaning to the left had improved by the time of the Consult.Plan:Bring back for Coomb's test (1 ml EDTA BS) and a POCUS exam.Phone call: 10:35 AM GMcP phoned Mrs Scott to discuss Lulu's blood results.Offered to bring her back for further testing.Mrs Scott wished to take Lulu to SASH.Requested VN M to email the blood results to SASH. GMcP to follow up with notes.    Vital Signs    Weight: 5.4;       MMColour: pink;       Temperature: 37.5;       HeartRate: 100;       BodyScore: 6/9;       DentalGrade: 1/4;       RespirationRate: 24;       CRT: 1 s;