C09994074 / invoice 10000

Reason: Inc RR and RE at Home - Heart DiseaseEMERGENCYHistory:Harvey was presented through emergency Sunday evening due to concern of an increased respiratory rate and potentially slightly more shallow breathing? Previous hx of advanced heart dx (see previous) - had echo with all hearts, owners awaiting comms with Gx team re final planOwners report his respiratory rate had been sitting in the mid to high 30s however has increased to 50-60 this eveningStill giving medications as prescribed Examination:Placed in oxygen at time of arrival / triage awaiting vet consult General demeanour: BAR, friendly Cardiovascular: HR 180 with gallop as previous, MM pink, CRT 1.5s Respiratory: RR 60 with mild effort, reduced to 40 in oxygen. Would not tolerate SPO2. No dyspnoea Abdomen: Soft and comfortable Radiology : TFAST - no pleural effusion evident, moderate B lines evident all fields. Initial Plan: + Client communication:Discussed no evidence of recurrence of pleural effusion however evidence of pulmonary oedema. In addition report from all hearts consistent with advanced cardiac dx. Offered inpatient v trial outpatient. Owners keen to trial outpatient this evening - aware if not improving needs reassessment / oxygen Plan to give 1ml (1.5mg/kg) frusemide this evening then give 1mg/kg TID (up from BID) for 2-3 daysAdvised INI or if worsening reassessment indicated ASAP. To discuss ongoing care with Gx team (owners advised are expecting a call Monday - I advised appears they are still waiting on email clarification) Referring Vet: Gx    Vital Signs