C10026421 / invoice 10000

Reason: GeorgiaAppointment Notes: Special payment terms exist, Overdue remindersIntern: GLHistory:Popcorn presents today for a recheck of liver parameters following cholecystectomy and liver biopsies performed on 4/2/25, and for reassessment of response to diet since changing to RC hypoallergenic. Popcorn was previously managed for a cholangiohepatitis which responded favourably to medical management. She subsequently developed a GBM and presented unwell on 4/2/26. A cholecystectomy and hepatic biopsies were performed and submitted for histopathology and culture. An O-tube was placed at the time of surgery. Histopathology of gall bladder and liver biopsies: DIAGNOSIS 1. GALLBLADDER MUCOCOELE 2. MILD TO MODERATE LYMPHOPLASMACYTIC AND NEUTROPHILIC PERIPORTAL TO RANDOM HEPATITIS, WITH MILD CHOLESTASIS Reported by: Dr. Emily JonesAt her last recheck on 27/02/26, OR Popcorn had been doing well at home with soft formed faeces. Her appetite and energy level has returned to her normal level with normal thirst and urination. O tube site had been healing well. In-house liver panel showed improvement with normal ALB, ALKP, TBIL, and mildly elevated ALT at 210 U/L (10-125).Today, O's friend R stool was normal looking, she has gained weight. No concerns with her appetite, stool, urination or drinking.Past pertinent history:- skin allergies- chronic intermittent GIT signsDiet: Current: R/C hypoallergenic kibble and wet food . Occasionally eats other dog's food (Prime 100 roast).Historical: Raw fed. Previously lyka and dry food but no change in frequency of GIt signs with any of these diets. Also tried RC gastrointestinal but continued to have soft stool.Examination Findings:T: NT MM: pinkP: 96 bpm    CRT: 1-2sR: pant Demeanour: BAR Hydration: euhydratedWeight: 7.9kg (+ 300g)Body Condition Score: 7/9Muscle Condition Score: 3/3Cardiovascular: WNLRespiratory: WNLAbdomen: WNLSuperficial LNs: WNLOcular: WNLEars: WNLIntegument:  Abdominal incision has healed.Oral exam: WNLMusculoskeletal: WNLNeurological: WNLRectal: NPLaboratory: ###In house liver panel:ALB 31 g/L 23 - 40 (cf  32g/L 27/2, 28 g/L 20/2  27g/L 11/2; 25g/L 5/2; 28g/L 4/2)					ALT  159U/L 10 - 125 H (cf 210U/L 27/2, 159 U/L  20/2: 342 U/L 11/2; 1688U/L 5/2; 2567U/L 4/2)								ALKP  101U/L 23 - 212 H (cf  95U/L 27/2, 163 U/L 20/2;  310 U/L 11/2; 966U/L 5/2; 1390U/L 4/2)						TBIL  6µmol/L 0 - 15 (cf 12umol/L 27/2, 7 umol/L 20/2; 8umol/L 11/2; 16umol/L 5/2; 70umol/L 4/2)Assessment: Problem List: - biochemical hepatopathy - reactive hepatitis - post op cholecystectomy for GBM 4/2/26- mild surgical site dehiscence (superficial, improving)Popcorn demonstrating excellent recovery from her cholecystectomy procedure. Today's mild increase in ALT may be reflective of ongoing hepatic recovery/resolution following previous GBM and hepatopathy, other reactive hepatopathy (eg secondary to GI disease), or could be indicative of underlying chronic hepatitis. Her stool has become firmer since starting hyp[oallergenic, suggesting a good response from her GIT.Plan:Recheck in 3-4mths. Continue RC hypoallergenic. Maintain current weight.    Vital Signs