C10020541 / invoice 10000

It is a legal requirement that vets examine animals every six months before prescribing most medications.

Last seen: 18.11.25 
Last blood test:
Next due recheck:18.05.26
Prescribed meds and dose: meloxicam 1.5mg/ml 180ml 25kg dose daily 
Confirmed meds and dose at time of request: yes 
Condition treated: oa
Initals:

It is a legal requirement that vets examine animals every six months before prescribing most medications.

Last seen: November
Last blood test: November
Next due recheck:  May
Prescribed meds and dose: meloxicam 180ml bottle please.  25kg dose tapering to lowest effective.
Confirmed meds and dose at time of request: as above
Condition treated: OA
Initals: Amy

Jennifer called back - spoke to AW 

Post op doing well, eating and toileting well. 
Asked about blood results relayed below results as per JC VM. O asked if results could be emailed. 
O also mentioned alternative meds discussion with JC, adv there was some notes on file about paracetamol but will let JC know so she can relay plan and discuss preferred dosages. O happy to await call/email from JC.


Phone call: Date (19/11/25) Time (17:38) Owner (Jennifer) Contact (Mobile) 
Outcome: No answer: (not able to LVM)
O called back; Spoke to O - 1743pm
Discussed bloods, discussed findings from medical w/up the other day, discussed plan.  emailed summary

Hi Jennifer, 

I hope Bruce is recovering well from his vet visit.   

As discussed, I have outlined our findings and plan going forwards

**Lab results
I have attached a copy of his lab results.  There are no concerning results - he has a mild elevation of CK which is a muscle protein that elevates with a injections and needles.  We are typically only concerned if this enzyme is in the thousands or higher.    

**Pain control**
1) Continue on 25kg dose meloxicam until he is comfortable and his pain is well controlled.  Once we reach this point, we can trial reducing his dose slowly, so we could try a 23kg dose for a few weeks.  If he shows signs of pain then we would go back to the 25kg dose.  If he doesn't show signs of pain then we could try reducing the dose further. 
2) Start paracetamol: 
Paracetamol  - 500mg tablets from the human chemist: 
Give 0.75 (three quarters) of a tablet twice daily (every 12 hours)
Stop and call us if vomiting/diarrhoea/yellow gums/not eating/otherwise unwell.  
Ensure tablets do not contain  xylitol, caffeine, ibuprofen or other additives.  Never give to cats.  
---We recommend a repeat blood test to check liver enzmyes 2 weeks after starting paracetamol.  ---
3) Continue the 4cyte

**Lumps**
Needle sampling showed that most lumps appear to be fatty lumps.  These typically stay the same and don't grow or change.  
The lump on his left side did show some extra cells that were spindle shaped.  We see these with inflammation, muscle tissue and fibrous tissue.  However, we also see these cells with more serious lumps like tumours.  We have the option of surgery to remove this lump.  Alternatively, we can monitor the lump. 
If any of his lumps grow/change then we should reassess: 

How to monitor the lumps at home:
Check each lump every 2–4 weeks and look for:
Growth – Getting noticeably bigger (e.g., >10–20% change)
Change in shape or feel – Becoming firmer, lumpy, uneven, or less movable under the skin
Skin changes– Redness, ulceration, hair loss
Pain – Your dog reacts when touched
Rapid change - – Any sudden growth over days to weeks
I have asked our reception team to email you a copy of his lump map which has the measurements of his lumps for you to refer back to.  Sometimes it can also be helpful to take a photo of the lumps with a ruler every month to help detected any changes.  

**Heart**
There are some early heart changes and occasional extra heartbeats (VPCs).
A Holter monitor (a 24-hour heart recording) is recommended as it gives the best picture of how often these extra beats occur, and will tell us if we should be starting any medications.  
Please monitor him for any signs of heart disease progress - these may include reduced exercise tolerance, breathing changes or fainting episodes.  

I hope this helps to clarify where we are up to with Bruce.  

Kind regards
Jenny