C10009968 / invoice 10000

Reason: Echo W/ Geoff Appointment Notes: Overdue remindersHistory: Cadiologist reuqeested gabba dispense to be given morning of echo    Vital Signs    

Reason: Health CheckAppointment Notes: ------- Sms reply: YSubjective:- Recheck consultation regarding a previously diagnosed heart murmur.- Eating and drinking very well. Increased appetite and receiving wet food treats multiple times per day.Past Medical History:- Previously diagnosed with a heart murmur. The diagnosis was made prior to the current pet insurance policy being initiated.Objective:-Assessment:- Heart murmur of unknown aetiology.Plan:- Investigations planned: Awaiting an appointment for cardiac imaging (echocardiogram) to diagnose the cause of the murmur and guide the treatment plan. Two options have been discussed with the owner:    - Referral to a specialist centre for imaging (estimated cost $1400).    - A visiting cardiologist to perform the imaging at our clinic (estimated cost $1000).    - An email has been sent to Dr Jeff, the cardiologist, to confirm his availability. We are awaiting his response.- Treatment planned: No medication is indicated at this time. Treatment will be based on the results of the cardiac imaging.- Relevant other actions:    - Advised owner to monitor sleeping respiratory rate. Counselled on using the "Cardalis" phone application to count and record breaths over 30 seconds to establish a baseline.    - Advised that routine weekly vet checks are not recommended as they may cause stress, which can negatively impact the heart. Advised to present for a check if any concerns arise.    - Counselled the owner regarding pet insurance. Discussed that since the heart murmur was a pre-existing condition, any future cardiac-related diagnostics or treatments may not be covered by the policy. Advised the owner to contact their insurance company to clarify coverage for heart-related issues. Suggested that if not covered, it may be more financially prudent to put money into a separate vet account rather than paying for an insurance policy that excludes the primary health concern. Medication costs may be discounted, but the full reimbursement (e.g., 80%) for specialist care would likely not apply.    - Reassured owner that surgical options are uncommon for most feline cardiac conditions; management is typically medical. The most significant initial cost is usually the diagnostic imaging.    - Will contact the owner once the appointment with the cardiologist is confirmed.--- 10/03/2026 09:18:08 AM KB2:Examinations - Resolved - Heard back from Dr Geoff about the echo booking. Can do next week Wednesday the 18th of March. Spoke wiht owner to confirm and we are all booked in. KK    Vital Signs    

Reason: Assess Heart Murmur Appointment Notes: owner had appt yesterday and sd heard heart murmur, reffered for geoff echo, o called wanting another check up today and disscuss hamu's heart more. o is aware not with sd, she could onlt do between 10am-1pm. lovley owner just not the greatest at english when it comes to medical terms BMHistory: Presented for recheck heart auscultationExamination: Full PEx not performedCardio: G3 heart murmur LResp: normal bronchovesicular sounds, normal effortLaboratory: Nil todayAssessment: Heart murmurTreatment: Nil todayPlan:Recommend Echo - discussed appt at VCA vs appt with Dr Geoff.Owner would like to go with Dr Geoff due to financial constraints - is aware there is a longer wait for this.Cost at VCA is $1400 for consult and echo. Discussed to monitor for any breathing difficulties/issues, discussed risks of clots.--- 04/03/2026 08:03:58 AM KB2:Examinations - Resolved - Sent courtesy follow up message. KK    Vital Signs