C09986931 / invoice 10000

04/03/2026 CLINICIAN: Duncan Durie 
PRESENTING COMPLAINT: 8 weeks post bilateral partial parathyroidectomy and cystotomy

HISTORY: 
Calcitriol 0.25mcg every third day, last had Monday am. Blood test 9am Wednesday 
O has noticed increase in appetite at home - started barking more for food as previously. Some weight gain despite no significant increase in food on offer other than maybe slightly more treats than normal 
Drinking, urination and defecation wnl 
No energy levels 
O reports mass on caudal ventral neck. Have seen reg vet for previously. Unsure if sampled. No changes observed. offered FNA today, o to pursue at local vet when under GA for dental in a few weeks' time

CLINICAL FINDINGS: 
BAR
TPR wnl 

DIAGNOSIS: 
Renal Pannel - wnl 
EPOC wnl except mild elevation in ionised calcium - 1.42mmol/L reference range upper 1.40mmol/L

ASESSMENT
Possible remaining parathyroid stimulating hypercalcaemia 
 
PLAN:  
Stop calcitriol
Monitor clinical signs closely, return sooner than 2 weeks if any concerns
Repeat ionised calcium in 2 weeks
If high, consider revision surgery for complete parathyroidectomy 
O planning to have dental in approx 3 weeks prior to holiday early April