C09979660 / invoice 10000

Reason: Dental Grade 2/3    Vital Signs    

Reason: Recheck Behaviour+ Take BloodsHistory: Doing well on the gabapentin - 100mg BID, not tried to wean down However as soon as this wears off he will start scartching again Not making him sedated Skin much improved - but did scratch his neck on thje way here Possibly urinating smaller volumes Eating well, no v/d/s/cMedications: pred 0.5ml SID - but nothing last 2 days Examine: gained 170g in 2 weeks Grade 2-3 dental dzRHS neck - hair regrowing but acute self trauma on the way here Hair growing back elsewhere Assessment: sounds as though there has been a positive response to the gabapentin Howrver has been previously allergy tested and confirmed so likely at least part allergic componentHow much the teeth could also be affecting him from an anxiety point of view???Plan:TAHP for dental and possible ongoing meds Continue gabapentin for nowAssessment: Bloods unremarkableOk to proceed with dental + extractionsOk for additional anti anxiety meds if needed May be interesting to see how he is after a dental - owner wondering how much oral pain could be contributing to the anxiety/overgrooming --- 23/02/2026 16:31:38 KAW:Text sent to call for results --- 23/02/2026 17:16:43 KAW:Neck looking good - managed to get a soft cone which helps Gabapentin 100mg - helping to relax him wellRelayed bloodsOwner keen to book in dental --> will book for 3rd march $1400-2300 as has had pre GA bloods Laboratory: Hb 125 g/L (96-161) WBC 4.7 x10 /L (3.6-14.0) 9RCC 7.6 x10 /L (6.7-11.6) Neut 4.0 x10 /L (1.8-9.6) 12 9Hct 0.35 (0.30-0.48) Lymp 0.4 x10 /L (0.7-6.2) 9MCV 46 fL (37-50) Mono 0.1 x10 /L (< 0.8) 9MCH 17 pg (12-17) Eos 0.1 x10 /L (0.1-1.2) 9MCHC 360 g/L (313-360) Baso 0.0 x10 /L (< 0.2) 9RET-He 16.4 pg (12.6-21.1)Red cells : Normal.White cells : Lymphopenia +.Platelets : Platelet clumps ++,Platelets Clumped: Numbers appear adequate on film..Note: Due to the presence of platelet clumping (2-3+) the plateletestimate may be inaccurate hence not performed.Fasting status RandomSodium 151 mmol/L (148-157)Potassium 4.4 mmol/L (3.5-5.3)Chloride 118 mmol/L (100-125)Bicarbonate 18 mmol/L (14-21)Anion Gap 19 mmol/L (18-29)Urea 12.0 mmol/L (5.5-11.9)Creatinine 110 umol/L (79-186)Plasma Glucose 4.4 mmol/L (3.7-7.5)Bilirubin 1 umol/L (< 5)AST 24 U/L (28-64)ALT 33 U/L (21-88)GGT < 5 U/L (< 3)Alkaline Phosphatase 25 U/L (12-50)Protein 69 g/L (60-82)Albumin 34 g/L (29-43)Globulin 35 g/L (25-46)Albumin/Globulin Ratio 1.0 (0.7-1.4)Calcium 2.37 mmol/L (2.19-2.81)Phosphate 0.90 mmol/L (1.00-1.80)Creatine Kinase 191 U/L (69-718)Cholesterol 3.2 mmol/L (2.1-7.8)Triglyceride 2.4 mmol/L (0.1-0.6)Total T4 24 nmol/L (18-45)    Vital Signs    Weight: 6.89;       

Reason: Thinks Is Anxious, Over Grooming, Off FoodHistory: is hyperallergenic. Owners were away for a couple of weeks and have come back and has gotten out of control. Neck is out of control and has been licking excessively on stomach/thorax. Licking of ventrum is new. Have changed his diet - has been a bit picky recently. Usually on steroids is ravenous but now isn't as keen on food. Eating FF satchets still. Had diarrhoea for a couple of days when coming back. Got back from holidays roughly 3 weeks ago. Licked his bum raw ++. Have been using e-collar on/off. Diet: usually on t/d diet or c/d kibble (mixing up brands) + FF satches Medications: pred 1.5mL SID - 3 days SID then taper downWill wait for a flare up and then start pred tapering course - usually once every 3 months however is becoming more frequent Examine:Mm p+m, CRT<2s, dental 2-3/4Heart - initially gallop rhythm then settled to regular rhythm, no murmur heardAbdo palp comfLns wnl Neck at jugular site approx 2x2cm hot spot on RHS, 0.5x0.5cm on LHS At sternum aprpox 2x2cm hot spotBarbered alopecia on ventrum Laboratory: sticky tape of neck hot spotneutrophils ++ cocci ++ Treatment: Convenia 0.68mL SC Assessment: overgrooming - ddx severe allergy flare +/- component of behavioural stress related overgrooming  Plan: Recheck skin/beahviour in 2 weeks + collect bloods for greyP (could not do as 2x hot spots on neck at site of jugular). May need long term anti-anxiety meds - fluoxetine vs clomicalm Recc dental once skin/behaviour sorted if bloods ok. Owners keen - advised may need multiple extractionsRecc bacicorten cream BID - owners have at home Recc reducing pred to 1mL (5mg) SID for 3-5 days then tapering if tolerated Discussed trialling feliwayGabapentin anti-anxiety trial - 100mg PO BID for 5 days then taper down to 50-75mg PO BID (anti-anxiety but not excessively sedate = optimal dose)--- 09/02/2026 12:50:46 LI:F/up - doing ok, scratching less with the gaba on board - hoping this helps settle things and can do the bloods in a couple weeks    Vital Signs    Weight: 6.72;