C09995569 / invoice 10000

Appointment Notes: Special payment terms exist, Overdue remindersIntern: GLDRAFTHistory: Morris presented for a recheck of his ITP and ongoing management for food-responsive enteropathy.He had been diagnosed with non-associative ITP on 14/09/24. Prednisolone was discontinued on 9/04, and on 12/05, cyclosporine was reduced from 50mg PO SID to 25mg PO SID for two weeks, then every other day for another two weeks, before being discontinued as he remained in remission.At his last recheck on 1/7/25, Morris had been doing very well, with no ongoing concerns. He had completed his cyclosporine about four weeks prior. His appetite remained stable, although he had gained a small amount of weight. He had not experienced any gastrointestinal issues or changes in energy levels, and the owners hadn't noticed any relapse of bruising, petechiae, or epistaxis. Overall, they were very happy with his progress. The owners mentioned that they had expanded his diet to include beef liver and cooked chicken, but Morris had not shown any relapse in his chronic enteropathy.Morris continued to be in remission for his non-associative ITP after all immunosuppressive agents were discontinued. Biochemistry showed mild to moderate hypertriglyceridemia, likely due to a post-prandial effect since he had been fed prior to the blood test. His CBC/MBA would be reassessed in two months after a 12-hour fast. If his fasting triglyceride level remained above 5mmol/L, fenofibrate and/or dietary fat restriction might be considered.On 24/9/25, Morris remains stable, been EDDU well at home, has good energy and goes for regular exercise. There have been no gastrointestinal signs since February. A new flavour of dry chicken flavoured kibble was introduced without issue. Today, OR Morris is doing very well at home with no concerns, OR occasionally he gets soft stool after eating something outside of his normal diet, but this resolves quickly with no other signs.Prednisolone dosing history from discharge:24/10 - 27/10: prednisolone 30mg/d, cyclosporin 75mg PO BID27/10 - 3/10: prednisolone 25mg/d, cyclosporin 75mg morning, 50mg evening3/10 - 30/10: prednisolone 15mg PO SID, cyclopsorin 75mg morning, 50mg evening30/10 to 5/12: prednisolone 10mg PO SID, cyclosporin 75mg PO SID5/12 to 20/01: prednisolone 5mg PO SID, cyclosporin 50mg PO SID20/01 to 20/02: prednisolone 2.5mg PO SID, cyclosporin 50mg PO SID20/02 to 21/03: prednisolone 2.5mg PO EOD, cyclosporin 50mg PO SID21/03 to 9/04: prednisolone 2.5mg PO twice per week, cyclosporin 50mg PO SID9/04 to 12/05: cyclosporin 50mg PO SID12/05 to 1/06: cyclosporin 25mg PO SID1/06 to 14/06: cyclosporin 25mg PO EOD then discontinuedDiet: Prime 100 turkey. O has included dry kibbles (unsure of brand, chicken and rice), beef liver, cooked chicken into diet. Current medications:- Cobalazorb 500mcg PO q4-5d- Psyllium 1/2 tsp PO SID- Paws prebiotic digesticare. As required:- Ondansetron 4mg PO SID PRNExamination Findings:T: 38.3 C            MM: pink, moistP: 100 bpm       CRT: <2sR: pantingDemeanour: BARHydration: Euhydrated Weight: 13.7kg (stable) Body Condition Score: 5/9Muscle Condition Score: 3/3Cardiovascular: WNLRespiratory: WNLAbdomen: soft, comfortablePeripheral LNs: WNLOcular: WNLEars: WNLIntegument: WNLOral exam: mild periodontal disease 1/4 Musculoskeletal: WNLGait: WNLNeurological: mentation appropriate, full exam not performedRectal: normal faeces present on thermometerLaboratory:QML profileProblem List:Non-associative ITP - remissionChronic enteropathy - controlledBiochemical hepatopathy  - resolvedHypertriglyceridaemia - persistentAssessment: Morris still remains in remission for his non-associative ITP. His chronic enteropathy is also well controlled, and he has tolerated the expansion of his diet. Plan:Awaiting QML resultsReassess fasted CBC/MBA in 4-6 months time, then every year if no complications occur.    Vital Signs