C10028319 / invoice 10000

13/03/2026 Diagnosis:: Lymphoma, intermediate to large cell; B cell (ICC). Start UMW 19-week protocol. Week 11 Vincristine 

History:  Bobo’s appetite has been lower over the past week. though she continues to finish her food if her kibbles are mixed with salmon or meat. There is no vomiting or diarrhoea. Jenny is beginning to struggle to give Bobo her medications. Bobo's energy is slightly decreased but not markedly flat.  Bobo is currently receiving antibiotic therapy from RV for dermatological issues and suspected UTI. Otherwise there are no new concerns.  

Physical Examination findings: Bright, alert and responsive.
Oral: unable to exam the mouth (required muzzle)
Heart& lung: no murmur & arrythmia noted on auscultation. Normal respiratory rate and bronchovesicular sounds in all 4 quadrants
Abdomen:soft and comfortable, no masses or organomegaly
Rectal: soft stools on glove, no internal lymphadenopathy
LN:mildly prominent mandibular lymph nodes, all remaining peripheral lymph nodes palpate normally
Integ: interdigital dermatitis has improved significantly, yeasty odour still present
Mm pink, crt < 2 secs, HR102, RR 21, Temp 37.1, Wt: 18.9

Laboratory results: CBC performed in house with manual blood film assessment.
Hct:0.318
WCC: 15.02
Neuts: 11.63
Platelets: 342

Manual differential count:  Neutrophils 79%, Lymphocytes 14%, Monocytes 6%, Eosinophils 2%.
Platelets: clumped and adequate
Morphology: Normal 

In-house biochemistry; unremarkable

Treatment: 0.5mg vincristine was administered IV via a 22g catheter in the left cephalic vein using the closed injection Equashield system.
1mg/kg maropitant administered IV immediately prior to chemotherapy
- Cyclophosphamide - Give 150mg (3 tablets) (210mg/m2) orally on the morning of 20/03 with frusemide (1 tablet). CYTOTOXIC – Wear gloves and wash hands afterwards, do not break or split tablets.
Prednisolone 20mg: please give 1 tablet orally every other day for one week, reduce to 1/2 tablet twice a week for 2 weeks and discontinue.

Comments: It was a pleasure to see Bobo today.  We will see Bobo again in 2 weeks' time.  Please feel free to call or email if you have any further queries regarding Bobo.