C10008163 / invoice 10000

Reason: Discuss Dental And DietAppointment Notes: also want to chat about dental wihich will be under GA. will need blood test for previcox. one GA to get everything done. JK  ------- Sms reply: Y  ------- Sms reply: It's a Telehealth appointment with Dr Tyla so I'll be ready to answer from 3.20pm :)TC called Jen and spoke to her re concerns:- Had flare up of HL pain (suspected related to lumbosacral pain) and visited bvh afterhours 29/1. Dr Nigel rec dental S&P, spinal rads. Started on whole Previcox 227mg po sid, rec bloods in 1m post.- Farting more and poos were sloppier -- not known cause, is improving, added some cooked pumpkin into usual food (prime100 salmon + DC SKin and stomach), synbiotic capsules. Advised add 1t psyllium husk am and pm and see if helps further- Asked about changing diet to add Lyka -- if affordable and works for sheldon shouldnt be an issue. Also no harm keeping on current diet if going well.Current meds:- For HL pain/weakness - gabapentin 600mg po bid (increased to 600mg in am, going well, calmer and more himself); previcox 227mg po sid (in pm, helping pain a lot, seems much happier)- For colour dilution alopecia - Melatonin 6mg po bid; omegas bid po- For pruritis - Cetirizine 30mg sid (was on 40mg, made too sedate, giving 20mg in am/20mg pm made him go loopy); Cytopoint monthly -- thinks still a bit itchy after recent one, currently on 60mg monthly, could increase to 80mg.- Topical Nutriderm wash, conditioner and Barazone- Supplements -- Rosehip, Probiotics, 4cyte, AnitonePlan:- needs GA for nails, lump check, dental, spinal rads (+/- other if abnormalities on orhto exam. Will repeat physical and ortho exam once under. CBC/panel/usg (jen to collect urine morning of).Booked w TC 19/3/26, admit 9am.Prior to admit (2h) - 250mg traz + 600mg gabapentin (7am). At admit, Jen give TM medetomidine (trial 20mg/kg medetomidine TM this time, think 30mg a bit high last time). Then top up w torb if required. IVC placement, GA, do aboveClient communications:FROM DUNSBOROUGH VETS- Hi Jen, as discussed we have booked Sheldon for his procedure on Thurs 19th March, admission time 9am. The estimate for this would be $1600-1800, plus today's phone consultation. This would include general anaesthetic, full blood test, urine concentration test, dental scale and polish, spinal x-rays (+/- other x-rays if indicated eg of right fore paw), fine needle aspirate of lump(s), orthopaedic/physical exam under GA, fluids during general anaesthesia. Please remember to collect and bring in a sample of urine from Sheldon that morning, as discussed. No food after 9pm on the night before (Wed 18th) nor morning of the 19th, but he can have his medication as usual. On the morning of the procedure, 2 hours before admission (so at 7am), please give him 250mg Trazodone with his usual 600mg Gabapentin by mouth. If you have any further questions, please give us a call, otherwise we will see you then. Kind regards, Tyla.    Vital Signs