C09992539 / invoice 10000

Dear Harry,Thank you for your email.Gala should be okay to receive her immunisation as her previous IMHA was suspected to be secondary to the bee sting. We recommend an FBE prior to the immunisation and another one after the immunisation.In terms of speying Gala, if the owner would like to have the procedure performed here our surgery service is able to perform both procedures, and we can organise for an anaesthetist to be present similar to when she had her CT. Otherwise you could also organise for the anaesthetist to be present during the procedure at your hospital.We hope that helps.Kind regards,GuenMedicine internCAREAdministration & ReceptionCentre for Animal Referral & Emergency5 Hood StreetCollingwood VIC 3066P(03) 9417 6417F (03) 9417 6317Eadmin@carevet.com.auThis email (including any attachments) is intended only to be read or used by the addressee. It contains information that may be confidential and legally privileged. If you are not the addressee, or you have received this email by mistake, you must not disclose, copy or distribute it or use the information contained in it (or any attachments) in any way. If you have received this message in error please notify CARE by return email and then delete this message and any copies of it. Please also contact us if you have any doubts about the authenticity of this email. This email (including any attachments) may contain computer viruses or other defects. It is your responsibility to check this email and its attachments for viruses and defects before opening or forwarding them, and CARE is not liable for any loss or damage that may be caused by any such viruses or defectsFrom:Northcote Animal Hospital <info@northcotevet.com.au>Sent:Monday, 23 February 2026 11:47 AMTo:CAREVET Admin <admin@carevet.com.au>Subject:Re: Referral letter for Gala Capetillo from CARECaution:This is email originated outside the organisation. Do not click on links or open attachments unless you know the sender. If in doubt, please contact the IT Service Desk.Dear Dr Lim,Im Dr Harry Ellsmore  I saw Gala last week for her immunisation. We did not proceed because I wanted your opinion first.I consider her first adult vaccination important, but Im mindful it could potentially trigger an IMHA relapse. My proposed plan is to obtain a baseline CRP, administer the vaccine, then monitor CRP weekly and commence immunosuppression if there are signs of relapse. Do you think this is reasonable, or would you recommend a different approach (e.g., alternative monitoring, prophylactic therapy, or delaying vaccination)?Separately, the owners are keen for Gala to be desexed and have her four deciduous canine teeth removed at CARE. Can your team accommodate both procedures? If not, we will perform the dentistry after her spey here at nOah and follow whatever anaesthetic protocol you have found safe/recommend.Kind regards,Dr Harry Ellsmore

AttachedAssessment: The abdomen was essentially unremarkable, with no evidence of portosystemic shunting either extra hepatically, or intrahepatically. The elevated post-prandial bile acids may be a reflection of delayed clearance from microscopic disease or cholestasis. It may be that Gala has mild, microscopic vascular anomalies however this may not affect her overall survival time. Recommended Management Plan (Referring Vet to discuss with client): No specific treatment is recommended at this stage for Gala. Continue to monitor her biochemistry. We are happy to share her anaesthetic charts with your team, as her anaesthetic was smooth without complications; Gala may be anaesthetised in future utilising similar protocols.----------------tel comms with O - will book in vac and recheck with HE

IMHA secondary to bee sting