C10030885 / invoice 10000

Reason: VaccinationAppointment Notes: methimazole check up?Vaccination: F3Pre-consult nurse:SubjectivePresenting Concerns:  Fonzi presented for a recheck examination for hyperthyroidism. The owner reports that he has been doing very well on the transdermal thyroid medication.    Historical Conditions:-   Previously diagnosed with hyperthyroidism. Before treatment, the owner reported daily vomiting, lethargy, and constant overgrooming.  Diet/Appetite:-   The owner reports feeding pellets and Greenies treats.  V/D/C/S:-   The owner reports that the previous daily vomiting has completely resolved since starting thyroid medication.  Current Medications:-   Receiving 0.1 ml of intra-ear thyroid medication. The owner reports the last dose was administered at approximately 08:00 this morning.  Additional Information:-   The owner is interested in a new "click" style dispenser for the thyroid medication to ensure accurate dosing and will use up the current supply first.ObjectiveMentation: Bright, alert, and responsive  Wt: 5.4 kg  BCS: 5/9  T: 37 °C  P: 140 BPM  R: —  MM: pink/moist. CRT < 2sec.  Hydration: Normal    Emotional Assessment: The patient was very well-behaved and cooperative for the examination, vaccinations, and blood collection.    Eyes: Clear. No discharge or erythema OU.  Ears: Clean with no discharge or erythema AU. The owner reports no yellow discolouration of the pinnae.  Nose: Clear, moist without discharge.  Throat: No inducible cough upon tracheal palpation; no palpable masses.  Oral: Dental disease is present. Bleeding was noted on the left side. The right side appears to require a scale and polish.  Cardiovascular: No murmurs or arrhythmias, strong synchronous pulses.  Respiratory: Normal bronchovesicular sounds bilaterally.  Abdominal: No organomegaly or mass effects. No pain on palpation.  Lymph Nodes: No peripheral lymphadenopathy.  Integumentary: The coat is full and shiny. No evidence of ectoparasites.  Neurologic: No ataxia, normal mentation.  Musculoskeletal: Ambulation normal, no lameness observed.  Urogenital: Normal external anatomy.  Rectal: Not performed.    Point of Care Diagnostics: A blood sample was collected from the jugular vein for a thyroid level test. - the T4 is 32 and Cholesterol is 4.2 - both within normal limitsAssessmentHyperthyroidism - Well-controlled on transdermal medication. Clinical signs have resolved, and weight has increased appropriately. Awaiting thyroid hormone level results to confirm the current dose of 0.1 ml is therapeutic.    Dental Disease - Moderate dental disease noted, with gingival bleeding on the left side. A dental procedure is indicated.    Preventative Care - Patient is due for routine vaccinations.PlanVaccinations:-   Routine vaccinations were administered during the consultation.  Pending Diagnostics:-   A thyroid level test is being run in-house. I will telephone the owner with the results by 11:30 today to discuss if any dose adjustment is needed for the thyroid medication.  Medications/Treatments:-   Continue the intra-ear thyroid medication at a dose of 0.1 ml daily. This dose may be adjusted based on today's blood test results.-   A new "click" style dispenser for the thyroid medication will be ordered for the client's convenience for future refills.  Additional Discussion:-   A dental procedure, including a full-mouth assessment and scale and polish, is recommended to be performed within the next few weeks.-   Discussed scheduling the procedure for Wednesday, 1st April, to allow for at-home monitoring over the Easter holiday. Dr. Alex was recommended for the procedure due to his expertise with feline dentals.-   A cost estimate for the dental procedure will be sent to the owner.-   The owner was advised to contact the clinic if they have not received a call with the blood results by 11:30.-   The clinic will provide assistance with carrying the cat carriers from the car on the day of the dental procedure.    Vital Signs