C09987529 / invoice 10000

Reason: Zycortal injAppointment Notes: KMWent away for a few days and had some V+ and lethargy first nightGiven increase dose of pred and seemed to resolve Examine: BAR, BCS 6-7/9BW 33.2kg Oral Exam: DG 0-1/4Cardiovascular Exam: HR 100bpm, regular rhythm. HS WNL. MM pinkResp: RR pant, lung sounds clear Musculoskeletal Exam: NADLns WNLIntegumentary: coat looking good, NADTreatment: Zycortal ( Doxycortone Pivilate) 25mg/ml IM injectionRecommend fasted TG level next visit If still elevated might be best start RC gastro low fat -    Vital Signs    Weight: 33.2;       

Reason:  Wellness resultsLaboratory: Electrolytes WNLUrea slightly elevated - might be worth checking a urine sample for USGMild ALT elevation similar to previous results - likely from pred useVery high triglycerides. COuld be from steroids, or could be nonfasting sample Plan: Continue current dose of DOCP and keep an eye on hepatic valuesContact by Phone:STODiscussed bloods - Buddy had been fed about 3-4 hours before visit so potentially just post prandialSee if we can fast for 10-12h before next bloodsKeep an eye on ALT level - not concerning at this stage and has done poorly on lower dose of pred in past so stay where we are for nowRecheck on 27/02 for next DOCP or sooner if concerns    Vital Signs    

Reason: ZycortalAppointment Notes: csfSubjective: Due bloodsGenerally doing well, lots of energy and coat going better.Examine: BAR, full of beansEyes NADEars NADOral; MMS pink CRT <2sLNNs WNLCardiac: HR 96 chest clearAbdomen NADInteg: Coat looking goodAssessment: Clinically going well with regular DOCP injectionsPlan: Collect bloods today to check on electrolytes etcO likely to run out of pred before next visit. Advise if all is well with bloods I'll organise more; if bloods abnormal might need dose adjustmentAlso advised of prescription medication request system if needing meds in future.Treatment: Zycortal (DOCP) 1.8mL SQ    Vital Signs    Weight: 33.5;