C10018679 / invoice 10000

Reason: Consult And Cytopoint HJAppointment Notes: Overdue remindersCoughing - dry hacking coughDoesn't bring anything upSometimes triggered when excited or eating/drinkingSnoring has gotten louderBark has changed a bitBreathing when relaxed is stableNew heart murmurEnergy levels okayAppetite and toileting okaySkin is itchy again - has responded well to cytopoint previouslyExamination: BARCan't check mouthLN WNLNo tracheal sensitivityLungs clearGrade 1/6 systolic HMAbdomen comfortableSkin - generalised erythema especially pawsBCS 5/9Assessment: Coughing - suspected dynamic airway diseaseLow grade endocardiosisAllergiesTreatment: Cytopoint 10mg SQPlan: DIscussed cough - consider trial with anti tussives if gets worseWill monitor HM and consider echo if grade increases    Vital Signs    Weight: 6.6;