C10020523 / invoice 20000

Appointment Notes: u/ssent txtadmission: 0414795518no side effects medshistory of seizuresno recent illnessphenobarb 8pm last nightpreds not given this morningno deposit taken, pls call if we can do dental today/ if necessaryCC:Heart - musical grade4/6 holosytolic left apical murmur radiating to RHSHR=PR=140, ,pulse quality goodresp, lungs, mm, crt - okneeds dentalNo sedation**************CANINE ECHOCARDIOLOGY************			(5-10kg)PATIENT:		TURNER "Grommet"VETERINARIAN: 	Dr Catherine CoyleGrossly:  -	Left Atrium appears markedly enlarged.-	Right Atrium appears normal.-	Left Ventricle appears normal.-	Right Ventricle appears normal.-	Anterior mitral valve leaflet is thickened - 3.9m/s .  -	Left ventricular outflow tract appears normal.-	Pericardium is normal.-	ECG normal-	Myocardial contractility appears normal. Atrial Study:LAES:	3.34cm	(1.4-1.7cm)LAED:	2.95cmRAES:	1.76cmRAED:	1.46cmAo:	1.66cm	(1.5-1.8cm)LA:	3.47cm	(1.4-1.7cm)LA:Ao = 2.1	(<1.3)PA:La approx 1Ventricular Study:FS%:	%	(30-40%)LVIDd:   3.27cm	(2.7-3.2cm) LVIDs:	1.45cm	 (1.6-2.0cm)IVSd:	1.04cm	(0.6-0.7cm)  IVSs:	1.66cm	(0.8-1.0cm) LVPWd:	0.93cm	(0.5-0.7cm)  LVPWs:	1.66cm	(0.7-0.9cm)EPSS: 0cm (0-0.5cm) Doppler study:Across LA/RA: NADAcross LV/RV: NADMitral valve: Mod regurg, aliasing vmax >2.4m/sTricuspid valve: NADPulmonary valve: NADAortic valve: NADSUMMARY:Myxomatous mitral valve disease with mod to marked left atrial dilation - potentially close to CHF esp with high velocity regurg - potential to deteriorate quickly.Stage B2 - pimo indicatedStart cardisure 5mg - 1/2 BID (0.3mg/kg - upper limit of dose range)O to monitor RRR closely - potential for CHF soon.at least 2 week of cardiac meds and ABx 48hr prior before dental.    Vital Signs    Weight: 8.2;       

Appointment Reason: Vaccination, Appointment Notes: pr not due until march     Vital Signs    Weight: 8;