C09991423 / invoice 10000

Reason: Recheck IMHA Appointment Notes: Overdue remindersReason: History: Examination: Laboratory: Assessment: Treatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Plan:History-Update:    Vital Signs    

Reason: Follow Up Bloods - Call After 4pmPatient Information: - Percy - Dog - Date of examination: 10/02/2026 Subjective: - Phone call to update owner on recent blood test results for Immune-Mediated Haemolytic Anaemia (IMHA).Objective: - Diagnostic test results (ClinPath):  - Haematocrit: 39% (previously 33% on 30/01/2026).  - Platelets: 405 x 10^9/L.  - Nucleated red blood cell count: 1.6 x 10^9/L (previously 12.7 x 10^9/L on 30/01/2026).  - Reticulocytes: 126 x 10^9/L (previously 395 x 10^9/L on 30/01/2026).  - Blood smear: Occasional spherocytes, no agglutination, small number of reactive lymphocytes. Leukocyte count within normal limits.Assessment & Plan:1. Immune-Mediated Haemolytic Anaemia (IMHA) - Assessment: Improvement noted in haematocrit and inflammatory markers, indicating a slowing of the immune response. Haematocrit is now within the normal range. However, ongoing reticulocytosis and reactive lymphocytes suggest active red blood cell destruction and inflammation persist. Not yet in full remission. - Treatment plan: Continue all current medications without change. - Follow-up recommendations: Recheck bloods in one week, recommended for early in the week (Monday or Tuesday). Aim to assess for full remission, at which point medication tapering can be considered.Additional Notes: - Owner education provided: Discussed blood results with owner's contact (Jack), explaining the improvement but also the lack of full remission. Clarified that the bone marrow is still actively producing red blood cells, indicating ongoing destruction. Advised to maintain current treatment regimen and the importance of the follow-up blood test.    Vital Signs