C10002981 / invoice 10000

Reason: GAP? Recheck After Meds - Check Electrolytes Appointment Notes: THReason: Blood test recheck.Client Present: Alex Healthy Pets Wellness Testing: Bloods taken today for level one panel. Vaccination Type: Due in 4 weeks.Intestinal worming: NGSHeartworm Prevention: NGS Discussed risk; low as primarily an indoor dog.Flea Prevention: NGS Owner may have missed last dose due on 20/02/2026. Restarted today.Tick control: NGS Owner may have missed last dose due on 20/02/2026. Restarted today.Microchip: on fileInsurance and Healthy Pets Plus: HPP and insuranceBehaviour concerns: None. Demeanour is bright and happy.Current medications: Florinef medication. Dose was recently rationed by owner (1 tablet then 2 tablets, instead of 2 tablets twice daily). Also on ForthyronCurrent Diet: Owner concerned about weight gain. Appetite slightly increased, but not ravenous. GI upset noted, possibly due to dietary indiscretions. Receives a small bone once weekly which can cause a reaction.Toileting: GI upset reported. History: Presented for a recheck blood test (electrolytes and glucose). Owner reports increased energy and improved demeanour. Owner has been rationing thyroid medication due to running low. GI signs have returned despite initial improvement. Owner is concerned about potential weight gain. Examination:Demeanour: Bright and happy.Temperature: 38Hydration Level: AdequateEyes, Ears, Nose, Throat: Normal findingsCapillary Refill Time/Mucous Membranes: Pink, moist with a crt <2 secOral exam/Calculus level (0-4): Calculus score 1/4, gingivitis score 0/4.Cardiovascular/Heartrate: HR: 92 bpm, no murmur, no arrhythmia. Pulses strong and synchronous.Pulmonary/Respiratory: Lung sounds are clear, panting Peripheral Lymph nodes: Normal size and texture.Abdominal Palpation: Soft and non-painful.Urogenital: Normal externallyRectal: Normal externally Skin/Integument and Nails: Coat is full and normal appearing.Musculoskeletal/Neurologic function:Muscle Condition: Normal, symmetricalWeight: 29.2kg Pain Score (0-5): 0/5 Laboratory: Blood collected for a level one panel (electrolytes and glucose).PCV/TP 54/90SODIUM - 149      (previously 147) mmol/L 139 - 153 		POTASSIUM - 4.8 (previously 5.3) mmol/L 3.9 - 5.9 		CHLORIDE - 116 (previously 118) mmol/L 101 - 118Assessment:- Recheck for electrolyte status when taking florinef- GI upset. Treatment:- Cease thyroid medication- now that Ollie has been taking Florinef for the past 4 weeks. - Blood collection for level one panel.Consent has been given by the client to proceed with this treatment - yes Plan:- Stop thyroid medication.- Continue Florinef at 2 tablets orally every morning and evening. - Recheck thyroid level in 4 weeks.- Administer vaccinations at the 4-week recheck appointment.- Discussed restarting flea/tick prevention due to a potentially missed dose.    Vital Signs    Weight: 29.2;       HeartRate: 100;       DentalGrade: 1;       RespirationRate: panting;       PainScore: 0;       Temperature: 38;       CRT: <2;       MMColour: Pink;       BodyScore: 6;