C09996465 / invoice 10000

Reason: O Wanting To Buy A Box Of Yellow NeedlesAppointment Notes: SN    Vital Signs    

From: Jenna Rickards <jenna.rickards@nqcare.com.au> Sent: Wednesday, 4 March 2026 12:07 PMTo: Erin Howell <erinhowell21@gmail.com>Cc: NQ Care Admin <admin@nqcare.com.au>; MarlinCoast Admin <admin@mcvet.com.au>Subject: RE: Blood results for Olive HowellHi Erin,The typical dose is 10-30ml/kg under the skin per day. So for her, I would start with ~250ml under the skin twice a day and see how she tolerates that – it’s not a large volume. Any fluid is better than none if she can’t physically take in enough water to keep her hydrated in the face of her kidneys not concentrating any of her urine. You will find no difficulty in giving the SC fluids once you’re shown with your nursing background, and Olive will likely tolerate it well being a big dog. I think for now, I wouldn’t change anything else. Provided she is above that baseline we discussed (eating, drinking, urinating, defecating, walking and pain-free AND happy mentally) then we are doing right by her and us.I hope that helps!JennaDr	Jenna RickardsClinical Director, Internal Medicine SpecialistBVSc GCertSAECC ECVIM-CASay hi to your dog for me!  	 	07 4457 2000 	HYPERLINK "mailto:jenna.rickards@nqcare.com.au"jenna.rickards@nqcare.com.au 	HYPERLINK "http://www.nqcare.com.au/"www.nqcare.com.au 	232 Woolcock Street, Currajong QLD 4812I may send emails outside regular working hours. If you receive an email from me at that time, please feel free to respond during your normal working hours. At NQ Care we're always here for your furry friends.From: Erin Howell <HYPERLINK "mailto:erinhowell21@gmail.com"erinhowell21@gmail.com> Sent: Wednesday, 4 March 2026 9:44 AMTo: Jenna Rickards <HYPERLINK "mailto:jenna.rickards@nqcare.com.au"jenna.rickards@nqcare.com.au>Cc: NQ Care Admin <HYPERLINK "mailto:admin@nqcare.com.au"admin@nqcare.com.au>; Marlin Coast Veterinary Hospital <HYPERLINK "mailto:admin@mcvet.com.au"admin@mcvet.com.au>Subject: Re: Blood results for Olive HowellThank you so much Jenna,And for replying while you are on leave - I hugely appreciate that.  We did talk about subcut fluids - but we weren’t sure how much she would need? Because she is the 33kg. Would it be litres a day? If it was a reasonable amount and most dogs tolerate them okay, I would definitely be willing. I am an emergency nurse, so I would definitely feel comfortable learning if it would help and also help with her quality of life. At the moment she is getting:2ml SC maropitant at 0700 (I really think this does help) 8mg Ondans wafer at 1700 Losec 20mg BD (this was started while she was hospitalised last week) She is eating really well actually with this. She does have some intermittent diarrhoea and I have started some prokolin for this. She is still happy and bright. She is playing, and eating well and drinking. If you think subcuts would be useful and she wouldn’t need a massive amount I am happy to trial this as she does love her crate so I could probably tuck her into her crate with her wee toys and some snacks and she would probably happily have them. Happy to do anything else you suggest that might make sure she has a good quality of life in the time she has Thank you so much Erin    Vital Signs    

From: Jenna Rickards <jenna.rickards@nqcare.com.au> Sent: Wednesday, 4 March 2026 8:37 AMTo: Erin Howell <erinhowell21@gmail.com>; NQ Care Admin <admin@nqcare.com.au>Cc: MarlinCoast Admin <admin@mcvet.com.au>Subject: RE: Blood results for Olive HowellHi Erin (and Dr. Steven)I apologise for not calling but I am off work until next Tuesday and I didn’t want to delay your questions being answered.I am sorry to hear that Olive has had some deterioration in her kidney function. If she is tolerating the medications, then I would not stop them as some of them actually improve her quality of life.The other consideration is at home subcutaneous injections of fluid under the skin if you are comfortable with needles and Steven is happy to teach you how – this is a commonly performed at home treatment in kidney failure patients as long as everyone is comfortable with it, including Olive. We know she isn’t here for a long time, but we want it to be a good time. If there are medicines that are making her feel worse (sometimes phosphate binders can do that, and omeprazole can also cause diarrhoea in 10% of patients – but I don’t think she is having these medications currently), then I would stop those but continue with the others. Same goes for the diet. If she likes the kidney diet, then keep going with it. But if she doesn’t, then another diet is a compromise. She needs to eat something!Otherwise, is there anything more we can do? No, sadly not. In humans we can do hemodialysis, and even though it is technically possible in dogs too, there is no hemodialysis machine in QLD for pets. I hope that helps?I have cc’d Marlin Coast Vets into this so Steven knows where we are at.Cheers,Jenna    Vital Signs