C09984771 / invoice 10000

Appointment Notes: f3 + health check - had v+ and  d+ over the 20th + 21st feb. sk 24/2 History: EDDU normally, O concerned she's lost weightPreviously had radioactive iodine therapy for HyperT - 5 years ago V+/D+ 1.5 weeks ago - duration 3 days, no appetite. Seems to have resolved. Since unwell appetite has returned and appears back to normal, quite hungry but not ravenous, will eat more when offeredDiet: Dry & wet food Parasite prevention: UTDExamine: - minimal exam as cat quite cranky - hissing and growling Mentation normal, BAR Ears and eyes clearDental calculus grade 2-3/4, MM pink moist HR and rhythm normal, no murmurs RR and effort normal, clear on auscultation bilaterally Abdominal palpation normal - tense on exam but quite anxious, no palpable massesAmbulatory 4x limbs, no lameness, patellas normal/no luxations, good ROM in hips and stifles Lymph nodes normal, no enlargement Integument normal, no evidence of ectoparasites, hair coat healthy, nails normal Temperature not taken Options offered to O: 1. Complete blood profile today for general health assessment, including T4 - recommended under sedation, very spicy cat! O's consented. 2. If well vaccinateO's happy with plan. Cost estimate $500 for testing + vax. Signed consent form. Sedation: 0.15ml butorphanol + 0.23ml medetomidine IM in squish cage - cat flipped when receiving injection, unsure if entire volume given IM. Produced profound sedation after 10 mins. Diagnostics: CBC - NAD, RBCs lower end normalBicohem - NAD, mild hypokalaemia T4 WNL Plan:Advised delaying vaccination today given recent V+/D+ --> book for 2-3 months timeMonitor at home - if further V+/D+ cat will require further investigation - sedated xrays + U/S. Concerns for possible chronic GIT disease - IBD/lymphoplasmacytic enteritis, alimentary lymphpma    Vital Signs    Weight: 4.6;       HeartRate: 200;