C10026252 / invoice 10000

Reason: 1 Month RecheckAppointment Notes: Special payment terms exist, Overdue reminders  ------- Sms reply: YHistory: Had been fine up until the past 4 days. Has been eating Prime 100 duck - split into 3 meals per day - has skipped the morning meal on 2 occassions. Vomited bile twice yesterday morning. No dietary indiscretion. Faeces - have been a little mucoid and softer than normal in the past couple of days. Still panting unhanged. Not wanting to go for walks anymore - goes to the toilet and then comes back. Owner is having trouble giving the mycophenolate 90mg q24hr and cyclosporine 50mg in the morningCarter is presenting for a 1 month recheck (TPR, PCV/TP, CBC +/- imaging U/S vs thoracic radiographs). Carter is being managed for IMHA. Carter was last seen 13/02/26. At this time Carter was clinically well but has symptoms of excess corticosteroids, PCV/TP was stable, treatment was recommended to reduce prednisolone dose, with the remainder to be unchanged. A recheck in 1 month was recommended. External CBC demonstrated stable RBC parameters, with resolution of eosinophilia, but evidence of a neutrophilia with left shift and monocytosis – potentially drug induced vs associated with recent D+, have discussed with client potential imaging to investigate cause of foci inflammation vs observations.Current Medications: Mycophenolate 135 mg (3/4 tablet) PO q 12 hrCyclosporine 50 mg PO q 12 hr Prednisolone 5mg PO q 24 hr (reduced dose)Laboratory: Examination Findings: PCV/TP 38/84Assessment: Plan: Client Communication:    Vital Signs    Weight: 12.2;       MMColour: pink;       Temperature: 39.1;       HeartRate: 132;       RespirationRate: panting;       CRT: 1.5;