C10007223 / invoice 10000

History:Presenting for: Daisy presented for follow-up blood work following recent hospitalisation for suspected immune mediated haemolytic anaemia (IMHA). Initial blood count was 10, increased to 18 after first transfusion, then to 24 after second transfusion, and was 34 at discharge.Historical Conditions:- Recent hospitalisation for suspected IMHA with blood transfusions- Ultrasound examination performed during hospitalisation - results clearDiet:- Currently feeding 1.5 cups daily, owner planning to increase amount- Good appetite, actively seeking food in kitchen- Previously was 16kg, consciously reduced weight to just over a cup daily, then increased to current amountDrinking/Urination:- Doing a fair amount of drinking- Some urinary incontinence, especially noted in females on steroidsCurrent Meds:- Prednisolone (steroid therapy)- Clopidogrel (blood thinner) - quarter tablet daily, to be discontinued once RBC count stabilisedExamination:Mentation: BARWt: 12.1kgT: 37.7°CMM: Nice and pink, capillary refill <1 secondBehavioural: Good attitude, keen to get into mischief, readily accepts treats during examinationEars: Clean and clearOral: NormalCardiovascular: Clean chest soundsRespiratory: Clean chest soundsAbdominal: Soft, non-painful, no abnormalities palpatedLymph Nodes: Feel good, no abnormalities detectedMusculoskeletal: Good muscle mass maintained, appears a little too slimDiagnostics: Blood samples collected for PCV and complete blood countAssessment:Immune mediated haemolytic anaemia - Currently responding well to treatment with good mucous membrane colour and normal capillary refill time. Patient appears stable with good attitude and normal vital signs.Plan:Diagnostics:- PCV and complete blood count results to be sent to SASH for specialist review- Additional blood samples collected in case further testing requested by specialistsDiet Recs:- Increase daily food intake as patient appears underweight at current BCSClient Comms:- Blood results will be emailed to SASH specialists for review- Copy of results will also be sent to owner- Specialists will advise on medication adjustments based on current blood work- Clopidogrel to be discontinued once RBC count stabilised per specialist recommendation- Prednisolone taper plan to be determined by specialists, typically involves 6-month treatment period to allow immune system to settle- Follow-up appointment timing to be determined based on specialist recommendationsSpoke to owner: Hi David,Thanks for bringing Daisy to the clinic today.As a recap, we conducted a physical examination and took blood samples to check her red blood cell levels following her recent treatment for immune mediated haemolytic anaemia at the specialist hospital.The good news is that Daisy's gums are now a healthy pink colour, which is excellent progress compared to last week. Her chest sounds are clear, temperature is normal, and overall she's looking much better. Her attitude and energy levels seem good too.We've taken blood samples to check her packed cell volume and red blood cell count. I'll send these results to the specialists at SASH and let you know what they recommend for her ongoing treatment.Regarding her current medications - continue with the Prednisolone steroid and Clopidogrel blood thinner as prescribed by the specialists. They will advise when to stop the blood thinner once her red blood cell count has stabilised, and will guide the steroid tapering process over the coming months.Daisy has lost a bit of weight (now 12.1kg), so please increase her food portions. Given she's on steroids, her increased appetite is normal.I'll email you the blood results once they're ready and keep you updated on any recommendations from the specialists.Thanks,    Vital Signs    Weight: 12.1;       

Reason: Not Herself - Off Food, Water & Very LethargicAppointment Notes: (JP)Not herself thismorning, very flat, lethargic, not eating or drinkingHR - 140RR = 24MM = pale Tacky +OR pretty normal last night. Ate dinner (hypoallergenic RC) did a normal poo and went for a walk. No exposure to toxins however did possible eat a mushroom at the farm about 10days ago cause V+ D+ for 24hrs then fine after that. Gave Bravecto and drontol 2 weeks ago, UTD with all vax including lepto.Full bloods + Manual PCV = 10 TP = 60%    Vital Signs    Weight: 12.7;