C09982396 / invoice 10000

Appointment Notes: VETSTORIA - Dixie (Dog) - Louise Stark - 0417201547 - Consultation [Clinician : Dr. Annabel Tym(No Preference)] - Dixie has been listless, a distinct lack of energy and hasn't been eating (she is usually very demanding of food!)  Usually desperate for exercise, but has resisted walks.  -Web BookingClient name: Louise StarkContact number: 0417201547Email address: louise.sherwin-stark@hachette.com.auPatient name: DixieHas been more lethargic in the morningsPerks up by the afternoonEating smaller amount at nightHas been passing small amount mucusy liquid stool but this afternoon passed a normal reasonable formed stool on the way hereNo vomitingOn florinef for addisons- OR may have skipped a dose or two but tries to give it at night when eatingEx: QAR, HR 116, no murmur, chest clear, mm pink, a little tacky, crt 1s, grade 3 dental, bilateral nuclear sclerosis, abdo palp soft and comfortable, no spinal pain noted, rigid ROM hips, stifles and elbows, temp 38.6Anal glands- minimal normal content, L full compared to RCE otherwise okayStrongly recommended running bloods this afternoon esp to check electrolytes given she has Addisons- discussed concern can go into an Addissonian crisis. Other ddx gastro, hepatopathy, kidneys, other systemic illness, neoplasia.Owner declines bloods this afternoonGiven she has perked up this afternoon and passed a stool owner wants to see how she goesDispensed synbiotic to help Revisit if not back to her normal self tomorrow esp if vomiting, diarrhoea or not eating/drinking.Owner to go to emergency if any concerns during the night    Vital Signs