C10028112 / invoice 10000

Reason: Rv Heart Meds History: O has been measuring sleeping respiratory rates: consistently at approximately 26-28 O feels coughing is increased this week with some foamy phlegm Vaccination: UTD Tick/flea/worming /heartworm: Nexgard Spectra Current Medicatios:Pimobendan 0.25mg/kg PO BID (2.5mg PO BIDAllergies: Diet: Physical Examination: Behaviour: BAR ANXIOUS Neurological: proprioception and mentation normal Eyes: B/L cataracts. Ears: clean no dis charge Oral/Teeth: 2-3/4 PLNil;: No lymphadenopathy Respiratory: normal rate with some crackles on auscultationCardiovascular: MM pink , moist CRT <2s, regular heart rhythm, 5/6 LHS murmur rate 128Abdominal: relaxed, soft, non tender, no masses palpable Integument: skin clean no lesions visible Musculoskeletal: No pain or lameness BCS: 5/9 Urogenital: external appearance normal Temp: 37.9Rectal: unremarkable Diagnosis: Heart murmur ddx: MMVD, other Coughing ddx: CIRDC, CHF CCB, LP, TC, bronchomalacia, neoplastic, infectious, Other Likely progression of MMVDDiscussed progression of MVVD: Recommended starting Furosemide low dose 1mg/kg BID and review in 7 days. Will also add oral antibiotic. Advised O to continue measuring SRR. If patient gets worse or deteriorates advised to seek review here or at PET ER if after hours. Laboratory: Plan: 1. Continue cardisure 2.5mg PO BID2  Start Frusemide 2mg/kg 3 Start calvulox PO BID 4 monitor SRR5 review in 7 days 6 PET ER if deteriorates after hours. 06/03/2026 : Dr Michael Valentine BVSc.(Hons), BNgMiss L Chapman : Jax : Dog 9.4kg100.00 x Frusemide 20mgGive HALF tablet by mouth every 12 hoursKeep water available at all timesVet recheck due SEPTEMBER 202629/12/2025 : Dr Michael Valentine BVSc.(Hons), BNgMiss L Chapman : Jax : Dog 9.3kg90.00 x Cardisure 5mg Chewable Tablet  Give HALF tablet twice daily by mouth 1 hour before food (on empty stomach).Vet recheck due on JUNE 2026    Vital Signs    Weight: 9.4;