C09994668 / invoice 10000

Reason: RecheckAppointment Notes: Special payment terms exist, Overdue remindersReason: RecheckAppointment Notes: Special payment terms exist, Overdue remindersHistory: Diagnosis :1.  Presumptive immune mediated Panniculus, lymphadenitis and pneumonitis based on rapid clinical response to Prednislone administration and remission mained with cyclosporine long term.Biopsy of ulcerative cutaneous lesion 2/2/24 shows pyogranulomatous inflammation, microbial culture negative.Thoracic CT 14/2/24 shows severe diffuse patchy alveolar pulmonary patter. BAL 16/2/24 shows neutrophilic inflammation (after 1 dose dexamethasone and startingbroad spectrum antibiotic therapy). Microbial culture negative, and respiratory PCR negative.2. T3-L3 IVDDD; L1-2 Hemilameinectomy  28/7/253. T11-12  IVDD Hemilaminectomy 24/11/25Current medications :1. Prednisolone 5mg PO SID2. Cyclosporine 50mg PO BID as of 16/1; previously since cyclosporine re-started at 50mg PO BID in September, it was discontinued at time of hemilaminectomy November 2025 and re-started Jan at SID dosing.3. Clonadine 100mg PO SID held this morning.Trazadone given at 8am, but thew up.Current diet : 100 g cooked food of the following morning and night• Turkey mince• White quinoa• Butternut pumpkin purée• Zucchini• CarrotSupplements• Osteocare chew – 1 daily (with lunch)• Salmon omega oil – 2 pumps daily (1 per meal)• Eggshell powder – ¼ tsp daily• Greek yoghurt – 1 tsp daily• Turmeric – small pinch• Psyllium husk – ¼–½ tsp daily (as needed)• Green-lipped mussel powder – 1 capsule daily (opened, split across meals• 4cyte - 1 scoop• daily multi vitamins powder 1/4 spoon• prebiotics gut health power 1/4 spoon Appetite : NormalEstimated percentage DER : 100%Thirst : Normal Urination : NormalFaecal frequency : Daily to twice dailyFaecal consistency : Score 2Demeanour : BAROther clinical signs : Kavita noted 2 pustules over recent hemilaminectomy incision site last week, but this has ruptured and healed without further intervention. Seoul has otherwise been very well, recovering nicely from his recent hemilaminectomy.Examine: Weight : 6.7kgBody condition score : 6/9T:   RR: 20   HR:  140  MM colour: Pink   CRT    1secIntegument: Hemilaminectomy incision site healed well; previous pustule has resolved. .Eyes: NormalNose: Normal Ears: NormalOral: NormalLymph nodes: Peripheral lymph nodes palpably normalCardiac: No murmurs or arrythmias. Femoral pulses synchronous bilaterally Respiratory: Normal effort, bronchovesicular sounds to all quadrants. Abdominal palpation: Comfortable palpation. No palpable abnormalitiesRectal examination: Normal, formed stools.Neurological: BAR mentation, normal posture; HL ataxia; see Dr SL notes. Musculoskeletal: MCS 3/3.  Assessment:  Plan:  Communication:Medicine revisit summaryPrevious diagnosis:Current medications:Recent history:Physical examination:Demeanour - Bright and alertVital signs - MM pink, CRT<2s, HR  bpm, RR  bpm, T  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.Assessment:Treatment:Plan:Client communication:Vet communication:    Vital Signs    Weight: 6.7;       BodyScore: 6/9;