C10000859 / invoice 20000

09/02/2026 STFO was wanting app with Dr Kate as started coughing a little on and off and O concerned
Was unsure if she should up dose or not was able to give app Tuesday as Cancel app
O was hoping to speak to Dr KR before app as if we can up dose O can do before coming in

AL 


10/02/2026 Revisit reason: Recheck 
History: started coughing yesterday again, has been  a bit quiet
Medications:  pimobendan 1.25mg bid and frusemide 10mg tid
EDUF:  yes
Mentation:   bar, very growly/aggressive
BCS (0-5):       3/5- weight stable
HR: 120bpm, grade 5/6 left sided murmur as previous, no arryhthmia noted
RR: inc Rr in clinic (dog very stressed) lungs clear, no crackles
MM:                   pink (distance)
CRT: ne
Temperature: not taken
Dental Stage: ne
Any additional findings:  abdomen palpates soft, no fluid palpated

Assessment: worsening MVD with coughing vs increased  heart size => tracheal irritation vs bronchial disease

Treatment: continue pimobendan 1.25mg bid
Increase frusemide to 20mg in am, then 10mg in middle of day and 10mg in evening
O to measure RRR for next 7  days

On-going medications required: Y/N (use prescription tab for further supply):  Y pimobendan and frusemide

Plan: 
GapOnly Claim Insurance Summary

First Clinic Signs:    see previous     

Summary:   recheck for MVD- coughing has increased in last 24 hours                      

Diagnosis:      no crackles, abdomen palpates sfot, no fluid
HR 140bpm, grade 5/6 left sided murmur as previous, pulses = and strong                      

Treatment:  increase frusemide to 20mg in am then 10mg midday and afternoon

17/02/2026 Reason: Courtesy phone call 
Nurse:Jo
History:  coughing increased, meds dose changed
     Demeanour:
     Eating/ Drinking:
     Toileting:
     Any concerns?
     
Treatment:
     Medications being given:
     Patient taking meds as prescribed?

Assessment:

Next Appointment:

05/03/2026 Nurse initial:KC

Medication requested: Pimobendan 2.5mg (Cardisure) 


Any change in pets condition/symptoms: stable atm

Current dose being given (note any differences): yes

Any change in demeanour:  normal

EDUF, any changes: normal

Vomiting/Diarrhoea: no

Collection date: 6/03/26 5:00pm

Date of next revisit required: 21/04/26

Any other concerns/questions: still coughing a little bit in the morning.