C10019969 / invoice 10000

Re-examine and dispense Cobalazorb (B12)History: GIT disease and pancreatitis with Clostridium Perfringens overgrowth.Has been consulting with Dr Alex Kennedy at SASH Western SydneyCurrent meds: - Pred 5mg sid - Metronidazole 100mg bid- Maropitant 24mg sid - Paracetamol 125mg bidFed tidStill appears unsettle at night. Pacing about.Intermittent rapid breathing when asleep.Faeces more formed with intermittent frank bloodExam:BCS: 3/5 Has gained weight. Very settled Mm pink and moist. CRT 2 secs. Normal skin tentEyes and ears normalLN normalHR 120. No murmurAbdo palpation. No guarding, nausea or flank watching.Laboratory: None indicatedAssessment: GIT disease/pancreatitis appears to be resolvingBlood in faeces from excessive strainingTreatment: None in clinicPlan:Stop Cerenia:If ok after 4-5 days taper Pred. (2.5mg sid for 7 days then 2.5 mg eod for 10 days then 2.5mg twice weekly for 2 weeks)If ok then stop Metronidazole and commence Symbiotic.Commence Cobalazorb.SidAttempt to gradually reduce to BID mealsRe-examine in 7 days or sooner if deteriorates    Vital Signs    Weight: 10.33;