C10011437 / invoice 10000

Reason: Ongoing Cancer, O Thinks Getting Worse - Room 2History: Sep 2025 Dx by SASH 1. Focal exophytic distal jejunal mass. Neoplasia e.g. GIST/leiomyosarcoma, carcinoma or lymphoma areconsidered. Feline gastrointestinal sclerosing fibroplasia is considered less likely.2. Thickening of the small intestinal muscularis layer consistent with inflammatory enteropathy e.g. IBD orintestinal small cell lymphoma.3. Jejunal lymphadenomegaly consistent with reactive hyperplasia or metastatic neoplasia.4. Bilateral chronic nephropathy with big-kidney-little-kidney syndrome. Non-obstructive left nephrolith.5. Incidental accessory spleen/splenuncle.Nurse: SanchiPast few weeks more vocal, restless at night3 days hx of mucousy faeces, blood present3 days hx of v+ 4 times a day Current meds: on Thyronorm 2ml BID, doing 1.7ml BIDYesterday walked very uncoordinated, unstable and weak Examination: BARBCS: 2/9Ears: wnl –No redness/ discharge/ odour. Eyes: wnl – no discharge, corneal opacity, blephrospasmOral Cavity: Dental grade = 4/4Nose/Throat: wnl - No cough detectable on tracheal palpationCirculatory system: HR=150, MM=pink/moist, CRT <2 . No murmurs/arrhythmias Respiratory system: RR =23. No crackles/wheezesLN: wnl - SM, PS, and POP LN’s wnl Integument: wnl – no area of alopecia, erythema, lumps Abdomen: wnl – comfortable on abdo palp, no abnormal structuresMusculoskeletal: wnl – walking in consult appropriately. Full musco exam not performed Urogenital: wnlNeurological – Normal mentation, full neurological exam not performedTemperature 37.3Laboratory: Tahp results pending Assessment: V+/D+, weight loss (prev 2.7 in jan 2026) Advised the jejunal mass may be causing obstruction, if V+ continues next 24 hrs with maropitant, to go SASH emergencyRecom to revisit SASH for speicalist u/s Did discuss QoL - O wanting to do bloods as base, advised the v+/D+ most likey related to jejunla mass, less likely caused by hyperT Treatment: Maropitant 0.2ml SC Pro kolin 2ml BID Consent has been given by the client to proceed with this treatment  -  Yes/No Plan:O to revisit SASH asap Call O with blood results    Vital Signs    Weight: 2.35;       Temperature: 37.3;