C10008318 / invoice 20000

0416351599harness walks only - no lead walks can have calming meds if needed meds- cardisure and frusemide this am no extras est 2000deposit 1000ko CC:Examine: BARHeart - , lungs, resp - apting excessibvely - coyld not hear anythng!, mm, crt - okTreatment:0.6ml But + 0.3ml alfalxaone  IV for echo *** continued to pant excessivel though examadditon of 0.2ml med + 0.2ml ket IV for abdo- smooth spontaneous timely recoveryImaging:**************CANINE ECHOCARDIOLOGY************			(25-30kg)PATIENT:		VETERINARIAN: 	Dr Catherine CoyleGrossly:  -	Left Atrium appears moderately enlarged.-	Right Atrium appears normal.-	Left Ventricle appears normal.-	Right Ventricle appears normal.-	Anterior mitral valve leaflet appears thickened 5.5mm width-	Left ventricular outflow tract appears normal.-	Pericardium is normal.-	Cardiac rhythm and rate appear normal. -	Myocardial contractility appears normal. Atrial Study:LAES:	5.78cm	(2.1-2.5cm)LAED:	4.70mRAES:	3.79cmRAED:	3.68cmAo:	        2.47cm	(2.4-2.6cm)LA:	        4.92cm	(2.1-2.5cm)LA:Ao = 1.99	(<1.6)PA: AO  = 1.15Ventricular Study:FS:	33%	(30-40%)LVIDd:   5.75cm	(4.4-4.8cm) LVIDs:   3.83cm	(3.1-3.4cm)IVSd:	1.45cm	(0.8-1.0cm)  IVSs:	2.15cm	(1.3-1.4cm) LVPWd:	1.17cm	(0.7-0.9cm)  LVPWs:	1.82cm	(1.2-1.3cm)EPSS:    0.75mmDoppler study: Unable to get accurate doppler study due to excessive panting during examSUMMARY:Myxomatous mitral valve disease with moderate left atrial dilation - stage B2, pimo indicated.************ABDOMINAL ULTRASOUND************			PATIENT:		MONAHAN "Kruz"VETERINARIAN:  	Dr. CATHERINE COYLEBLADDER: NADREPRODUCTIVE STRUCTURES:  Prostate Abnormal - moderate to markedly symmetrically enlarged and hyper-echoic with smooth margins - 55.0 x 45.6mmAORTIC TRIFURICATION: NADL  KIDNEY:  NAD, Length 70.2mm. (Cats 3-4.5cm, dogs 5.5-9.1 x Ao diam at level of adrenal +/- cf other)R KIDNEY:  NAD, Length 63.8mm.L ADRENAL GLAND:  cranial pole 7.1mm, caudal pole 5.9mm, length 27.9mm. R ADRENAL GLAND:  Could not visualise due to excessive GIT gasSPLEEN:  NADLIVER: Abnormal - moderately diffusely enalrged and milldy hyper-echoic with coarse midly heterogenic paernachyma, margisn smoothGALL BLADDER: NAD - 34.9mm diam, mild echoic sludge(feline: wall < 1mm width, CBD=/< 0.4cm diam)GASTROINTESTINAL TRACT: - Stomach - Markedly dilated with gas, visible walls normal - 3.5mm(cats 0.2 to 0.44cm, dogs 0.3-0.5cm)- duo - 6.3mm(cats 0.22-0.44cm, papilla 0.29 to 0.55cm width, 0.4cm height; dogs <0.51/0.53/0.60cm wall <20/20-30/>30)- SI - Abnormal: diffusely thicekned mucosal alyer with perpendicual striations to lumen half of mucosa diffusely hyper-echoic, wall width - 6.4mm(jejunum:cats 0.21cm, dogs 0.2-0.3cm; ileum: cats <0.36cm, dogs <0.41/0.44/0.47cm S/M/L)- colon - NAD wall - 2.2mm, gas in lumen - 26.4mm diam(cats 0.17cm, dog 0.25 - 0.3cm, no contractions)PANCREAS: NAD (cat 0.5-0.9mm, duct 0.08cm <10yr, 0.12cm >10yr)PERITONEUM: NADLUMPHNODES: anabel to visualise GIT LNs doe to excessive colonic gas.SUMMARY:  1. Hepatopathy2. marked jejunal lymphangestasia with mucosal thicening - chornci eneteropthatyOPTIONS: 1.	    Vital Signs    Weight: 28.3;       

script for frusemide and cardisure    Vital Signs