C10022697 / invoice 10000

12/03/2026 Diagnosis:: Diffuse large cell lymphoma (histological diagnosis), Stage IIIA. IHC B -Cell. Vincristine week 14. 

History: 
Alice has been very well. Her appetite, thirst, toileting and energy levels remain normal.  There are no new concerns with Alice. 

Physical Examination findings: Bright, alert and responsive.
Mm pink, crt < 2 secs, HR124, RR 20, Temp 38.1, Wt: 41.9kg
Cardiovascular: muffled heart sound - likely anatomical 
Respiratory: normal respiratory rate and effort, normal bronchovesicular sounds on auscultation, no visible nasal discharge
Gastrointestinal: soft comfortable abdomen on palpation, no strong repeatable focus of pain,
Rectal exam: not performed 
Musculoskeletal: right tarsus markedly thickened and warm to the touch, there is no pain on manipulation or palpation
Neurological: cranial nerves intact, no notable ataxia
Integument: no obvious lesions
Lymph Nodes: right popliteal enlarged. soft to firm 


Laboratory results: CBC performed in house with manual blood film assessment.
Hct: 0.379
WCC: 3.38
Neuts:2.73
Platelets: 361

Manual differential count:  Neutrophils 60%, Lymphocytes 30%, Monocytes 8%, Eosinophils 1%.
Platelets: clumped and adequate
Morphology: Normal

Treatment:36.5mg doxorubicin (30mg/m2) was administered slow IV, in a saline infusion, via a 22g catheter in the right medial saphenous vein using the closed injection Equashield system.
Cerenia as required

Comments: We will see Alice again in 2 weeks time.  Please feel free to call or email if you have any further queries regarding Alice.