C09991820 / invoice 10000

Reason: Admit For Abdo Scan Appointment Notes: Overdue remindersBloods:- ALT >2000- ALP Abdp ultrasound:- Moderately enlarged liver - Ddx incl diffuse hepatopathy (inflammatory)- Gall bladder- pancreas WNL- Colon: some diarrhoea notedToxins? Plan:1) Ursofalk and Denamarin for one month then recheck liver enzymes +/- amoxyclav2) Total bilirubin, pre- and post-prandial bile acids. Also rec pancreatic lipase but unlikely pancreas is primary cause of elevated liver enzymes3) Liver biopsies - hold off pending blood resultsRec: 1) and 2) to start - O consented to planPancreatic lipase - WNLBilirubin and pre- and post prandial bile acids - to send to Idexx once have post-prandial bile acids. Winnie is not eating in hosp. O will bring her in once she eats breakfast tomorrow morning. After getting bie acid results:- Denamarin: Please give one capsule orally once a day. Give one hour before a meal. Liver supplement. - Ursofalk (10-15mg/kg PO divided into BID or SID) 250mg: please give half a tablet orally once a day an hour before food. - Amoxyclav 250mg: please give three quarters (3/4) of a tablet orally twice daily until finished.- Then recheck enzymes in one month    Vital Signs    Weight: 7.7;