C09984083 / invoice 10000

04/03/2026 Diagnosis: Mediastinal lymphoma, intermediate cell, intermediate to high grade; B cell, hypocalcaemia and low Vitamin D, start CHOP and calcitriol.  Start multi-agent chemotherapy, CHOP induction. Doxorubicin week 19.

History: Snoopy has been generally well. His family reported that he has experienced soft stools for over two weeks. Pro-Kolin was initiated on Monday, and there has been a slight improvement in stool consistency. His appetite and energy levels remain normal.

Physical Examination findings: Bright, alert and responsive.
Oral: mild periodontal disease + halitosis (previously)
Heart Lungs: no murmur or arrhythmia, normal RE and BV sounds on all quadrants
Abdomen: tense on abdominal palpation, but not painful
Rectal:no internal lymphadenopathy
Integ:no wounds, lesions and ectoparasites observed
Otic: significant improvement of the lichenification mild no erythema, yeasty odour still present
LN; no lymphadenopathy
Mm pink, crt < 2 secs, HR 96, RR sniff, Temp 38.5, Wt:18.8 

Laboratory results: CBC performed in house with manual blood film assessment.
Hct: 0.457
WCC: 6.08
Neuts: 3.78
Platelets: 332

Vitamin D test pending

Manual differential count:  Neutrophils 87%, Lymphocytes 4%, Monocytes 9%, Eosinophils 0%.
Platelets: clumped and adequate
Morphology: Normal 

Treatment: 19.2mg doxorubicin (27mg/m2) was administered IV via a 22g catheter in the right cephalic vein using the closed injection Equashield system.
- Ondansetron (Zofran) as required
- Continue Calcitriol 0.25mcg PO EOD
- Trazodone 150mg PO 2h prior vet visit 

Comments: It was a pleasure to see Snoopy
We will see Snoopy again in one months' time for his first post-chemotherapy treatment for a full blood profile and physical assessment.  Please feel free to call or email if you have any further queries regarding Snoopy.