C09995486 / invoice 10000

Appointment Notes: Special payment terms exist, Overdue reminders  ------- Sms reply: YHistory: Hs been doing well. Active in the morning and evening. Likes to sleep during the day. No changes or concerns since she was last assessed. Occasionally dietary indiscretion. No recent vomiting. No haematochezia or melan. Pixie is in for a 4 month recheck today.Pixie is being managed for a IMHA and IMN.Pixie was last seen on 07/11/2025 and doing fine, PCV stable. Treatment continued unchanged. Ferrograde 325mg tablets - give 1/2 of a tablet q24hrPrednisolone 5mg PO q 24 hr Cyclosporine 25 mg PO q 12 hr Needs script 5mg q24h and cyclosporine 25mg q12hrIron q24hrExamination Findings: Quiet, alert and responsiveHR - 96, RR - 32, mm pink, CRT 1.5 sec, Temp 38.1, Wt - 14.6kg, BCS 6/9Ears - mild amount of brown waxy discharge in the external ear canals bilaterally. Oral cavity - mild to moderate amount of generalised plaque and tartar. Halitosis. Gingivitis associate with the upper canines and the left upper cranial premolar teeth, Cardiorespiratory - Grade 1/6 left apical systolic heart murmur. Normal heart rate nd rhythm. Normal bronchovesicular lung sounds.Abdomen - tense and pot belly, unable to palpate any specific abnormalities Musculoskeletal - mildly tense on manual palpation of the cervical spineLymph nodes - normal palpation Skin - thinned coat dorsal abdomen. Mild scaling diffusely. Laboratory: PCV/TP - 38/110Blood was collected for an external CBC Assessment: Pixie is being managed for IMHA and IMN. Clinically she is doing well and her PCV is stable. An external CBC is pending Plan: Owner to phone on Monday for CBC results. If results are okay we will continue treatment unchanged and aim to recheck Pixie in 4 months Treatment: Prednisolone 5mg q24hr Cyclosporine 25mg q12hrAssessment: Plan: Recheck in 6 monthsClient Communication:    Vital Signs    

Reason: VN On File Appointment Notes: Special payment terms exist, Overdue remindersVETNOSTICS   Hb      110  g/L        (129-201)     WBC     9.4  x10^9  /L (4.7-12.8)    RCC    4.9  x10^12  /L (5.7-8.3)       Neut   7.2  x10^9  /L (3.1-9.0)    Hct   0.33             (0.38-0.57)     Lymp   1.4  x10^9  /L (1.0-3.5)    MCV     67  fL         (63-75)         Mono   0.8  x10^9  /L (0.2-1.0)    MCH     23  pg         (22-27)         Eos    0.0  x10^9  /L (0.1-1.0)    MCHC   338  g/L        (328-378)       Baso   0.0  x10^9  /L (< 0.2)  Plat    601  x10^9  /L  (150-539)  Retic   1.6  %          (< 2.1)   abs.     78  x10^9  /L   RET-He 20.1  pg         (21.3-28.1)   Red cells   : Normal.   White cells : Normal.   Platelets   : Thrombocytosis +.                              VETNOSTICS COMMENT   non-regenerative anaemia persists.   Bruce Duff   Veterinary PathologistAssessment:The CBC results indicate that Pixie's neutrophil could is normal. She continues to have a mild anaemia and mild thrombocytosis. Both of these results are similar to her last recheck to slightly better. I would recommend to continue treatment unchanged and recheck her results in 4 months time.Client Communication: --- 11/11/2025 14:34:35 CCD:Called Alice, went to VM. Left a message advising that I would email, and if she had any questions to call back and discuss further. Hi Alice, I hope Pixie and yourself are well. I attempted to call you this afternoon, but unfortunately reached your voicemail. Please find below Dr. Tim's assessment for Pixie's recent complete blood count: The complete blood count results indicate that Pixie's neutrophil count is normal (as prior). Pixie continues to have a mild anaemia (mild reduction in her red blood cell count) and mild thrombocytosis (mild elevation in her platelet count). Both of these results are similar to her last recheck to slightly better. As such, we would recommend continuing treatment unchanged. We would recommend a recheck (repeat complete blood count) in four months' time. Please get in contact via our reception team to schedule Pixie's next recheck. If you have any questions or concerns, please don't hesitate to get in contact. Kind Regards, Dr. Cheska DowrickMedicine Intern at ARH HomebushOn behalf of Dr. Tim Hugo Small Animal Internal Medicine Specialist    Vital Signs    

Reason: 2 Month Recheck - by Sterre van Veldhuizen Appointment Notes: TH okay with intern to see client (23.9.25 CK)Pixie is in for a 2 month recheck today. Pixie is being managed for a mild progressive anaemia. Pixie was last seen on 02/09/2025. At this time, an abdominal ultrasound with urine sampling was performed. No abnormalities apart from T 37.3 Results: chronic changes in the kidneys, a metabolic hepatopathy and evidence of a mild enteropathy. No evidence of melena. Urine NAD. Currents Medications:Iron supplementation for two months ? Ferrograde 325mg tablets - give 1/2 of a tablet SIDPrednisolone 10 mg PO q 24 hr --> 1/2 tablet SID Cyclosporine 50 mg PO q 12 hr --> 25 mg BID History: Doing super well: energy fine, EDDU NAD. No blood in stools/urine, only vomited once, no blood. No coughing or sneezing. Has a few lumbs.  Examination Findings: AI BAR BCS 7/9, weight 13.8 (lost 100 grams)A: 32 CA normal effort, ausc NAD P: kress 80, ausc NAD T: 37.8 Skin and coat: turgor wnl, coat shiny, skin NAD MM: pink, moist, CRT <1. Teeth: calculus 3/4 canines, rest 2/4. Gingivitis canines 3/4, rest 2/4. Lnn: NAD. Lumps:On left size abdomen - black, ~ 0.5 cm diameter, round --> expressed sebaceous material. On ear R - since 2 week, ~ 0.5 cm diameter, round, not warm/painful. Expressed sebaceous material yesterday, now crustae on top. Has been there since a week after visit to groomers. On LHL on dorsal aspect tarsus: ~ 0.8 cm diameter, round, pink, not painful, no hairs. Unclear how long its been there or if has been growing in size. Laboratory: PCV 33/90CBC pending Assessment: Pixie is being managed for IMHA and IMN. Doing well at this point, no abnormalitites on PE apart from BCS, teeth and lumps. Owner has no current concerns. PCV is stable. An external CBC is pending.Plan: Recheck VN CBC, we'll call with results. Lumbs advised FNA short term, preferably today, especially for LHL. Dental advised. Client Communication:Advised O on plan, we'll call with CBC once we have results. Depending on results, we will communicate when we would like to see Pixie for a recheck and if we'll change medications. Offered FNA here, RV will probably be cheaper --> O elected to go to RV.    Vital Signs