C10031151 / invoice 10000

Appointment Notes: PCV + recheck?????SUMMARY* Presenting for: Recheck for immune-mediated haemolytic anaemia (IMHA).* Assessment: Clinically improved since the previous consult. Suspected IMHA secondary to a urinary tract infection.* Treatment and plan: Continued steroid therapy. Monitor packed cell volume (PCV). Recheck in one week.HISTORY* Recheck for IMHA, diagnosed Tuesday.* O reports patient is brighter and eating better. Was very flat on Tuesday, improving since.* EDDU well.* Current medication: steroids.EXAM* Demeanour: BAR. Brighter than previous consult.* Body condition score: /9* Ambulation: normal around consult room* Eyes: eyes clear, no signs of conjunctivitis, pupils symmetrical and normal size* Mucous membranes: moist, pink, CRT < 2sec. Pinker than previous consult.* Teeth: grade /4 perio* Skin: no skin lesions or unusual masses noted, normal skin tent* Heart: heart and lungs auscultated. Nil murmurs or arrythmias. Bilaterally clear lung fields.* Pulses: Strong and synchronous* Abdomen: abdominal palpation normal, no pain or obvious masses identified* Lymph nodes: within normal limits* Other: Perivulvar conformation may predispose to ascending UTIs.ASSESSMENT* Immune-mediated haemolytic anaemia (IMHA) - showing positive response to treatment.* Likely secondary to a recent urinary tract infection.PLAN* In-house PCV performed. Vet to contact O with results via message or phone call.* Continue current steroid medication as directed.* Recheck consult scheduled for next Tuesday to repeat PCV.* Long-term plan to slowly wean steroids.* Consider full haematology panel in the future to monitor progress.CLIENT COMMUNCIATION* Reinforced the long-term nature of steroid therapy and the goal to wean off gradually.* Discussed the possibility of relapse and the potential need for other medications if the response is inadequate.* Advised continued monitoring at home. O is already checking gum colour frequently.13/03/2026 8:06:28 AM JW:PCV: 24TP: 60??13/03/2026 3:53:30 PM MDV:Client communication: Spoke to client RE: PCV from this morning. Advised was not urgent but that EB would call later this arvo. - mdv??    Vital Signs    Weight: 44.5;       

EB AUTH  written script: CLOPIDOGREL 75mg (28 tablets)Give ONE tablet ONCE daily 2 repeats allowed11/03/2026 3:48:57 PM AJN:script dispensed as per EB notes - sitting in tray for collection @ CVC. client will need to pay script fee on collection. Rx Clopidogrel 75mg tabletsSig: Give ONE (1) tablet by mouth ONCE daily ongoing until finished.Mitte: 28 tablets (with 2 repeats allowed).    Vital Signs