C10027892 / invoice 10000

Appointment Reason: Not eating, Appointment Notes: jh was booked in on wednesday for x-ray and cardiac u/s owner concerned not eating will come fasted and see what we can get done today jhHISTORY- Coughing (hacking cough), initially constant, now throughout the day. Possiblly slight improvement with NSAID - Loss of appetite, requiring hand feeding since last night - Previous diagnosis of heart murmur- No V+ or D+DIAGNOSIS- Heart murmur and Arrhythmia- Wheezing in lung and Coughing ddx: CHF vs primary pulmonary dz (CCB, penumonia, neoplasia)- Hyporexia PLAN- X-ray and ECG to assess heart and lung +/- sed - Possible administration of Frusemide - Recheck and further treatment planning after initial tests    Vital Signs    Weight: 7.6;       MMColour: Pink;       Heart: Abnormal (G4/6 heart murmur; irregular heart rhythm);       Lungs: Abnormal (Genralised wheezing );       Demeanour: BAR;       Temperature: 38.3;       RespirationRate: 30;       HeartRate: 150;       BodyScore: 5;       CRT: 1-2;       

Examine:IV catheter placed. 0.08 ml butorphanol and 0.15 ml frusemide given slow IV. Adequate sedation.  Radiographs taken of the DV thorax, right and left lateral views.Heart is enlarged on radiographs and pushing up the trachea. Slight pulmonary oedema. VHS 12.5Assessment: CHFWill commence meds and review next week.ECG taken- sent through to RW, confirmed sinus rhythm.    Vital Signs    

Owner came down, cough is better but still not 100%Extend anti-inflam course, I was between consults so didn't have time to speak to client but plan would be another week of rimadyl and if still not better needs cardiac work up.    Vital Signs