C09988960 / invoice 10000

Reason: Revisit - IMPA/PLEMedicine revisit summaryPrevious diagnosis:Previous diagnosis -- Protein losing enteropathy with inflammatory (eosinophillic, suppurative) biopsies- IMPA, suspected reactive to GI disease- Historical neutrophillic hepatitis and lymphadenitis when investigated for the PLE.Has been on a tapering course of prednisolone (+hydrolysed diet), but relapsed increase in CRP and low albumin when prednisolone reduced to 2.5mg EOD in 2025 increased back to 5mg SID, with response. Commenced tapering again as polyphagia a concerning steroid adverse effect - consistent relapsing CSx and CRP increases so Neoral added Feb 2026Current medications:- Trazodone prior to appt - Prednisolone 2.5mg SID - Synbiotic DC probiotic in the evening - Neoral 100mg q q 24 hour Recent history:Happy in herself Regurgitation has resolved Defecation has been fine, formed, a bit softer but still holding their shape Physical examination:Demeanour - Bright and alertVital signs - MM pink, CRT<2s, HR  bpm, RR  bpm, T 38.8 CCardiovascular - Cardiac auscultation normal, pulses strong and synchronousRespiratory - Effort normal, bronchovesicular sounds audible all quadrantsAbdomen - No abnormalities on palpationHead / neck - No abnormalities identifiedMusculoskeletal - Normal gait, no pain identifiedIntegumentary - No abnormalities identifiedGenitourinary - No abnormalities identifiedLymph nodes - Peripheral lymphadenopathy not detectedBCS  /9. Body weight  kg.Ear cytology (scabbed lesion): Cocci +++, neutrophils + Assessment:Treatment:Plan:Client communication:Vet communication:    Vital Signs