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Patient History Report

Client: Prado, Jason (4591) Patient: Lucy (8601)


Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

8/28/2017 TC VD MAH Client Communication - TENTATIVE - RECORDS REQUEST


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
8/28/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

Client Communication

Time: 5p

Discussion: O called and requested records be sent to jasonprado@live.com. O said they will be in TX for the next couple
of months so she is going to find a vet there.
Pending DVM approval.

Initials: vj

8/29/17 8:40a Approved per Dr. Larson. Emailed and received okay. vj

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 1 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

8/11/2017 C KL MAH Client Communication - FINAL 08/11/2017 - Labwork


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
8/11/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

2 PM- LMOM for owner to call us back to let us know how Lucy is doing and to make sure they got our message last week.
I'm hoping some of the loose stool is starting to clear on the proviable, but call and let us know. Called number
832-231-5124. KL

-411pm- O cb and said that he got our message. P seems to be doing better and gaining weight back. E/d OK, no D+ and
has good energy. Let O know thats good. I will give the doctor the update and if she has any additional questions, will give
him a cb on Monday. O said OK, thank you. JW.

8/8/2017 C KL MAH Client Communication - FINAL 08/08/2017


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 2 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

8/8/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

5:30 PM-- Called 832-231-5124 - rang twice and no answer and no machine. Will try again tomorrow.
KL

8/5/2017 C KL MAH Client Communication - FINAL 08/06/2017


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
8/5/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 3 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

2 PM- Called owner on 8322315124- LMOM for owner to call back Monday to go over results of labwork- things are
looking better, but there are still some abnormalities- her liver enzymes are back to normal but her she does still have some
anemia. Would like to see how she is doing, if the proviable is helping with the stool any yet, etc. Please call back Monday.
KL

8/4/2017 L MK Chemistry results from IDEXX Reference Laboratory Requisition


ID: 106020421 Posted Final
Test Result Reference Range
SPEC cPL 30 ug/L 0 - 200
Ascn: 7901224406

8/4/2017 L MK Hematology results from IDEXX Reference


Laboratory Requisition ID: 106020421 Posted Final
Test Result Reference Range
BASO 0.1 %
EOS 6.7 %
HCT 35.9 % L 38.3 - 56.5
HGB 12.2 g/dL L 13.4 - 20.7
LYMPHS 28.2 %
MCH 25.0 pg 21.9 - 26.1
MCHC 34.0 g/dL 32.6 - 39.2
MCV 74 fL 59 - 76
MONOS 9.7 %
NEUT SEG 55.3 %
PLATELETS 539 K/uL H 143 - 448
RBC 4.88 M/uL L 5.39 - 8.70
RETIC CNT 0.8 %
WBC 17.7 K/uL H 4.9 - 17.6
ABS BASO 18 /uL 0 - 100
ABS EOS 1186 /uL 70 - 1490
ABS LYMPHS 4991 /uL H 1060 - 4950
ABS MONOS 1717 /uL H 130 - 1150
ABS NEUTS 9788 /uL 2940 - 12670
ABS RET 39 K/uL 10 - 110
Ascn: 7901224406
RE: 3180 RETICULOCYTE COMMENT
RETICULOCYTE COMMENT
A reticulocyte count of greater than 110 K/uL of blood is
considered
evidence of bone marrow response to an increased peripheral
demand.
Depending on the degree of anemia, a reticulocyte count <110

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 4 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

K/uL may
indicate an inadequate bone marrow response. Serial
monitoring of the
erythrogram and reticulocyte count may be useful to evaluate
bone
marrow responsiveness over time.

The following chart may be used as a guideline to determine


appropriateness of regenerative response.

Degree of bone marrow response (K/uL):


Mild 110-150
Moderate 150-300
Marked >300
RE: 3034 REMARKS
REMARKS
SLIDE REVIEWED MICROSCOPICALLY.

8/4/2017 L MK Chemistry results from IDEXX Reference Laboratory Requisition


ID: 106020421 Posted Final
Test Result Reference Range
ALB 2.9 g/dL 2.7 - 3.9
ALKP 128 U/L 5 - 160
ALT 90 U/L 18 - 121
ANION GAP 17 mmol/L 11 - 26
AST 29 U/L 16 - 55
BICARB 20 mmol/L 13 - 27
BUN/UREA 24 mg/dL 9 - 31
Ca 9.9 mg/dL 8.4 - 11.8
Chloride 119 mmol/L 108 - 119
CHOL 104 mg/dL L 131 - 345
CREA 1.2 mg/dL 0.5 - 1.5
DBIL <0.1 mg/dL 0.0 - 0.1
GGT 2 U/L 0 - 13
GLU 88 mg/dL 63 - 114
IBIL 0.0 mg/dL 0.0 - 0.2
PHOS 4.9 mg/dL 2.5 - 6.1
Potassium 5.0 mmol/L 4.0 - 5.4
TBIL 0.1 mg/dL 0.0 - 0.3
TP 6.1 g/dL 5.5 - 7.5
TRIG 33 mg/dL 20 - 150
Sodium 151 mmol/L 142 - 152
A/G Ratio 0.9 0.7 - 1.5
B/C Ratio 20.0
Na/K Ratio 30 28 - 37
GLOB 3.2 g/dL 2.4 - 4.0
CK 217 U/L H 10 - 200

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 5 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

SDMA 12 ug/dL 0 - 14
Ascn: 7901224406
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.

BOTH SDMA AND CREATININE ARE WITHIN THE REFERENCE INTERVAL


which indicates
kidney function is likely good. Evaluate a complete
urinalysis and confirm
there is no other evidence of kidney disease.

8/4/2017 L MK UA/Microscopy results from IDEXX Reference


Laboratory Requisition ID: 106020421 Posted Final
Test Result Reference Range
BACTERIA NONE SEEN
BILIRUBIN NEGATIVE
BLOOD NEGATIVE
CASTS NONE SEEN
CLARITY Clear
COLOR Dark Yellow
CRYSTALS SEE NOTES
EPI CELL RARE (0-1)
GLUCOSE NEGATIVE
KETONES NEGATIVE
MUCUS NONE SEEN
PH 6.0
PROTEIN NEGATIVE
RBC 0-2 HPF
SP GRAVITY 1.041
UROB NORMAL
WBC 0-2 HPF 0 - 5
Ascn: 7901224406
RE: 900 COLLECTION METHOD CYSTOCENTESIS

OCCASIONAL AMMONIUM MG PHOSPHATE (0-1)/HPF


Protein test is performed and confirmed by the
sulfosalicylic acid
test.

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 6 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

8/3/2017 C MK Quick Recheck - FINAL 08/03/2017

Recheck _Here for recheck. She is doing better, she has gained weight. No v/d or c/s. E/d is normal and energy level
is back to normal. She is still on the Denamarin and she finished the Clavamox.
Soft formed stools, flatulent, mm-pale/tacky, BCS 3/9_

Recommendations
Discussed soft stool and flatulence may be results of bacterial imbalance due to abx or original illness not resolved.
Adult screen with spec cPL to Idexx - will call with results
Consider testing for addisons, cobalmin/folate?, and consider need for prescription diet after bldwk review, but would not
expect addisons to change liver function per bile acids results.
Recommend ultrasound if bldwk values not improved or resolved.

Tgh with Proviable as directed - see rx

tech initials: ja
Doctor: Monica Kimber, DVM

8/3/2017 P MK 1.00 bottle of Proviable DC Caps 80 Cap Btl (1407)


Rx #: 73019 Exp. 12/31/18 0 Of 0 Refills Filled by: JA
Give 1 capsule by mouth once daily.
8/3/2017 CK KL Seems to be doing a bit better. O is running late. mf
Reason for Visit: Recheck
Date Patient Checked Out: 08/03/17 Practice 0
8/3/2017 V KL Aug 3, 2017 04:22 PM Staff: KL
------------------------------
Weight : 15.40 pounds

8/3/2017 T JW Image: Estimate


7/28/2017 CB SW Callback - Callback Reminder (CBACK)
---- Note from Jamie N. Wells on 7/28/2017 at 09:48:38 ----
Called to check in on P. O says seems to be doing a bit better, is putting on weight
again. Let O know about recheck, O scheduled for Wednesday.

7/18/2017 C SW MAH Client Communication - FINAL 07/19/2017

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 7 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

Maricopa Animal Hospital


19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
7/18/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

How is P doing? Ps lepto test came back negative which is really good. The bile acids were moderately elevated
which is consistent with some liver dysfunction but not bad enough to be a shunt. Would need ultrasound to confirm that,
can refer to imaging specialist for that. If P is doing good/seems to be improving, recommend continuing on medication and
rechecking in 2 weeks.
SW

4:10pm Called and lmom stating above info. Asked O to give us a call back to let us know they got our message.
ja

7/14/2017 T MF Image: Estimate/Admissions


7/14/2017 P SW 1.00 bottle of Denamarin 225mg Chew Tabs (1403)
Rx #: 72459 Exp. 02/28/19 0 Of 0 Refills Filled by: FR
Give 1/2 tablet by mouth every 24 hours.

Give on an empty stomach 1 hour before a meal.


7/14/2017 P SW 30.00 tablet of Clavamox 62.5 mg tablets (OM015)
Rx #: 72458 Exp. 06/30/18 0 Of 0 Refills Filled by: FR
Give 1 1/5 tablets by mouth every 12 hours till gone.

Give on a full stomach


B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 8 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

7/14/2017 C SW MAH Client Communication - FINAL 07/15/2017


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
7/14/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

Client Communication Here for a consultation, & drop off for bile acids testing.

Time: 10:00
Discussed with O about Ps bloodwork. Repeated previous client communication discussion of recommendations
1. Bile acids test. Explained that this is a liver function test and will help us rule in/out if P has an underlying genetic
condition called a liver shunt. Since P is younger, this is a possibility, but not very high chance.
2. Referral to imaging specialist in Gilbert for ultrasound. Recommend this to help get better idea of what exactly is going
on in liver.
3. Recommend starting on abx and liver protectant (Denamarin), in order to treat any possible infection. Would recommend
doing this no matter what follow-up diagnostics want to pursue.
4. Lastly would recommend checking for disease called leptospirosis. It affects the liver and is bad because it can actually
be transmitted to humans so we would be checking for it just to be safe.

O asked where would recommend starting cost-wise. Recommend abx and denamarin, then bile acids test. Explained
concern for leptospirosis, would be good to have that test done as well since it is a human health hazard. Depending on the
answers from the followup diagnostics, may need to pursue further imaging at specialist. O would like to do bile acids and
lepto PCR today. P has been fasted for 12 hrs.
B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 9 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

Discussion: Bile acids pre- drawn at 10:35 am, also drew blood for the Leptospira real PCR test- told owner it takes 1-3
days for results to come back- will call when they come in.
Feed Science Diet Low Fat I/D
Post bile acids drawn at 12:35 pm- Idexx pending- will call owner with results
TGH- Clavamox & Denamarin- See Rx
Also let O know that valley fever titer was negative.

Initials: FR

7/14/2017 CK SW Reason for Visit: Consultation


Date Patient Checked Out: 07/14/17 Practice 0
7/14/2017 V SW Jul 14, 2017 09:48 AM Staff: SW
------------------------------
Weight : 13.20 pounds

7/14/2017 L SW Chemistry results from IDEXX Reference Laboratory Requisition


ID: 105701419 Posted Final
Test Result Reference Range
BILE ACIDS 54.3 umol/L H 0.0 - 6.9
BILE ACPP 25.1 umol/L H 0.0 - 14.9
Ascn: 7901201846

TUBE ORDER AND LABELED DRAW TIMES RECHECKED


RESULT VERIFIED BY REPEAT ANALYSIS
Elevated pre or post-prandial bile acids are suggestive of
decreased liver
function, but do not indicate the nature of the abnormality
or whether the
problem is reversible or permanent. Normal bile acids do
not rule out the
presence of hepatic disease.
Mild elevations (15-30) may also be seen with extrahepatic
diseases (e.g. small
intestinal bacterial overgrowth (SIBO),
hyperadrenocorticism, etc.) If clinical
signs and other diagnostic findings are suggestive of
primary liver disease,
consider additional diagnostics to further evaluate the
liver, including repeat
bile acids panel in 2 to 4 weeks.
Moderate to severe elevations (>30) are consistent with
hepatic dysfunction,
but cannot discriminate specific liver diseases or the

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 10 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

relative severity of
liver disease. Additional diagnostics (e.g. ultrasound
and/or liver biopsy)
are recommended to further classify the disease process.
Note: If the serum bilirubin concentration is elevated or
the animal is
icteric, there is little additional diagnostic value in
performing a bile acids
test.
RESULT VERIFIED BY REPEAT ANALYSIS

7/14/2017 L SW Miscellaneous results from IDEXX Reference


Laboratory Requisition ID: 105701419 Posted Final
Test Result Reference Range
LEPTO BLD NEGATIVE
LEPTO UR NEGATIVE
Ascn: 7901201846

A POSITIVE LEPTOSPIRA RESULT indicates that DNA from


pathogenic
Leptospira was detected in the sample(s) submitted. In
animals with
clinical signs this supports infection. Acute infection
causes
anorexia, fever, lethargy with laboratory parameters
indicating organ
injury in kidney, muscle, pancreas, and/or liver. Leptospira
positive
urine samples have to be considered a source of infection
for other
animals and humans.

A NEGATIVE LEPTOSPIRA RESULT indicates that Leptospira DNA


was not
detected in the sample(s) submitted. However, a negative PCR
result
may be caused by the numbers of organisms being below the
limit of
detection, decreased numbers of organisms following
treatment or
chronic carrier state, or the occurence of new strain
variations.

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 11 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

7/13/2017 C VD EMAIL SENT - CLOSED 07/20/2017


EMAIL SENT

Sent over discussion notes from Dr. Woods. vj

7/13/2017 C SW MAH Client Communication - FINAL 07/13/2017


Maricopa Animal Hospital
19950 N. John Wayne Pkwy P.O. Box 129
Maricopa, AZ 85139
(520) 568-2224

Client Communication
7/13/2017

Client ID: 4591 Patient ID: 8601


Client Jason Prado Name: Lucy
Name:
Address: 20261 N. Herbert Ave., Species: Canine - Corgi
Maricopa, AZ 85138 Sex: Female
Telephone: (832) 231-5124 Color: Sable
Markings:
Birth Date: 8/10/2016

Client Communication

Time:
10:31am

Discussion:
Called and tto about Ps bloodwork resutls. Explained that Dr Larson is out of town and so I will be taking over Ps case for

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 12 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

her. Went over elevations in liver enzymes and anemia. Explained that we are worried about Ps liver, possibly an infection.
Couple options for next steps,
1. Bile acids test. Explained that this is a liver function test and will help us rule in/out if P has an underlying genetic
condition called a liver shunt. Since P is younger, this is a possibility, but not very high chance.
2. Referral to imaging specialist in Gilbert for ultrasound. Recommend this to help get better idea of what exactly is going
on in liver.
3. Recommend starting on abx and liver protectant (Denamarin), in order to treat any possible infection. Would recommend
doing this no matter what follow-up diagnostics want to pursue.
4. Lastly would recommend checking for disease called leptospirosis. It affects the liver and is bad because it can actually
be transmitted to humans so we would be checking for it just to be safe.
O asked if these could be done in one test. Let O know we could add on the Lepto to the bloodwork already sent to the lab,
but the bile acids are a separate test. We fast them for 12 hrs, then take a sample, then feed them, then four hours later
take another sample. This helps evaluate if the liver is able to clear the byproducts of food breakdown and assess the liver
function. O asked if we could email him this and then if he could come down with P and go over it and decide what to do.
Told O that was fine, can definitely do that.
Email: jasonprado@live.com
Scheduled for consultation tomorrow at 9: 45 am

Initials: SW

7/12/2017 L KL SNAP Assays results from IDEXX VetLab In-clinic


Laboratory Requisition ID: 5724 Posted Final
Test Result Reference Range
HW = Negative
Lyme = Negative
AP_spp = Negative
EC-EE = Negative

7/12/2017 T VD Image: Estimate


7/12/2017 P KL 15.00 mL of Panacur 100mg/ml (AP025)
Rx #: 72393 Exp. 10/31/18 0 Of 0 Refills Filled by: ML
Give three (3) mls by mouth once (1) a day for 5 days.

7/12/2017 C KL SOAP new - FINAL 07/14/2017

SUBJECTIVE/HISTORY
Here for exam. Owner said that he has noticed wt loss with in the last 3 weeks. Owner went out of town and came

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 13 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

back and noticed the difference. Still e/d-good, no v/c/s. A little bit of soft stool. They did change her diet, its still puppy food.
Decrease in energy. Is current on vx through vet in CA, owner didnt bring paperwork. Owner said that he doesnt think she
had a stool check done. Had a heat cycle in April. __
Diet: blue buffalo puppy
Current Medications/Supplements: none
Vx Hx: current on vx through vet in CA-owner didnt bring paperwork.
Attitude: _QAR_
Technician's initials: {ML}

OBJECTIVE/EXAM
T: 101.4 P: 160 R: pant. MM: pink CRT: <2
BCS: _4/9_
Oral: wnl
Ophthalmic: wnl
Otoscopic: wnl
Coat/Skin: wnl
Respiratory: wnl
Cardiovascular: wnl
Abdominal: wnl
M/S: wnl
Neuro: wnl
Lymph nodes: wnl
Other: __

ASSESSMENT
_Weight loss/slight lethargy- intestinal parasites, bacterial, fungal, viral, rickettsial, renal, open_
Prognosis: fair-good

PLAN
Discussed with owner that overall pet does seem a bit more relaxed than typical corgi pup. And if she has been
losing a bit of weight there are concerns. Is possible she could have intestinal parasites- asked owner if her stools are
loose- per owner they are occassionally a little loose but they recently changed her diet so think it is from that. Recommend
checking a fecal and checking bloodwork. Discussed VF, TF, intestinal parasites, or other possible causes of weight loss.
HW4DX- negative all four
Fecal and cocci profile to Idexx- will call with results.
Recommend going ahead and doing a dewormer for pet even if fecal comes back negative.
TGH with panacur as directed. See Rx. _
Follow up: _pending labwork _

Doctor: Kelly Larson, DVM

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 14 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

7/12/2017 CK KL LMOM to confirm appt.


Reason for Visit: Appointment
Date Patient Checked Out: 07/12/17 Practice 0
7/12/2017 V KL Jul 12, 2017 01:53 PM Staff: KL
------------------------------
Weight : 13.00 pounds

7/12/2017 L KL Hematology results from IDEXX Reference


Laboratory Requisition ID: 105665235 Posted Final
Test Result Reference Range
BASO 0.1 %
EOS 13.9 %
HCT 37.6 % L 38.3 - 56.5
HGB 12.5 g/dL L 13.4 - 20.7
LYMPHS 31.0 %
MCH 24.8 pg 21.9 - 26.1
MCHC 33.2 g/dL 32.6 - 39.2
MCV 74 fL 59 - 76
MONOS 5.5 %
NEUT SEG 49.5 %
PLATELETS 354 K/uL 143 - 448
RBC 5.05 M/uL L 5.39 - 8.70
RETIC CNT 0.9 %
WBC 14.8 K/uL 4.9 - 17.6
ABS BASO 15 /uL 0 - 100
ABS EOS 2057 /uL H 70 - 1490
ABS LYMPHS 4588 /uL 1060 - 4950
ABS MONOS 814 /uL 130 - 1150
ABS NEUTS 7326 /uL 2940 - 12670
ABS RET 45 K/uL 10 - 110
Ascn: 7901201384
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
Ascn: 7901201384
RE: 3034 REMARKS
REMARKS
SLIDE REVIEWED MICROSCOPICALLY.
REACTIVE LYMPHOCYTES PRESENT
B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 15 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

7/12/2017 L KL Chemistry results from IDEXX Reference Laboratory Requisition


ID: 105665235 Posted Final
Test Result Reference Range
ALB 3.1 g/dL 2.7 - 3.9
ALKP 229 U/L H 5 - 160
ALT 794 U/L H 18 - 121
AMYL 421 U/L 337 - 1469
ANION GAP 13 mmol/L 11 - 26
AST 40 U/L 16 - 55
BICARB 22 mmol/L 13 - 27
BUN/UREA 9 mg/dL 9 - 31
Ca 10.5 mg/dL 8.4 - 11.8
Chloride 111 mmol/L 108 - 119
CHOL 104 mg/dL L 131 - 345
CREA 0.7 mg/dL 0.5 - 1.5
DBIL 0.1 mg/dL 0.0 - 0.1
GGT 5 U/L 0 - 13
GLU 100 mg/dL 63 - 114
IBIL 0.1 mg/dL 0.0 - 0.2
LIPA 84 U/L L 138 - 755
PHOS 5.2 mg/dL 2.5 - 6.1
Potassium 4.8 mmol/L 4.0 - 5.4
TBIL 0.2 mg/dL 0.0 - 0.3
TP 5.6 g/dL 5.5 - 7.5
Sodium 141 mmol/L L 142 - 152
A/G Ratio 1.2 0.7 - 1.5
B/C Ratio 12.9
Na/K Ratio 29 28 - 37
GLOB 2.5 g/dL 2.4 - 4.0
CK 116 U/L 10 - 200
SDMA 19 ug/dL H 0 - 14
Ascn: 7901201384
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
Ascn: 7901201384
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 16 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

SDMA IS INCREASED AND CREATININE IS WITHIN THE REFERENCE


INTERVAL. IDEXX SDMA
Test is a more reliable indicator of kidney function than
creatinine because
SDMA detects declining kidney function earlier and is not
impacted by muscle
mass. Creatinine can miss early function loss and be falsely
decreased in
patients with poor muscle mass. SDMA increases in acute and
active injury as
well as chronic kidney disease. A complete urinalysis should
be performed to
evaluate for inappropriate specific gravity, proteinuria and
other evidence of
kidney disease. If SDMA is 15-19 ug/dL and there is other
evidence of kidney
disease, action should be taken. If SDMA is 15-19 ug/dL with
no other evidence
of disease, recheck in 2-4 weeks. If SDMA &#8805;20 ug/dL or
is persistently
15-19 ug/dL, regardless of whether there is other evidence
of kidney disease,
action should be taken. For information on recommended
actions visit:
www.idexx.com/SDMAalgorithm
Note: In puppies, SDMA reference interval is 0-16 ug/dL.
SDMA reference
interval studies are underway for kittens and Greyhounds,
and results should be
interpreted in light of other findings.

7/12/2017 L KL Endocrinology results from IDEXX Reference


Laboratory Requisition ID: 105665235 Posted Final
Test Result Reference Range
T4 2.3 ug/dL 1.0 - 4.0
Ascn: 7901201384
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
Ascn: 7901201384

Interpretive ranges:
<1.0 Low
1.0-4.0 Normal

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 17 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

>4.0 High
2.1-5.4 Therapeutic
Dogs with no clinical signs of hypothyroidism and results
within the
normal reference range are likely euthyroid. Dogs with low
T4
concentrations may be hypothyroid or euthyroid sick .
Occasionally,
hypothyroid dogs can have T4 concentrations that are low
normal. Dogs
with clinical signs of hypothyroidism and low or low normal
T4
concentrations may be evaluated further by submission of
free T4 and
canine TSH. A high T4 concentration in a clinically normal
dog is
likely variation of normal; however elevations may occur
secondary to
thyroid autoantibodies or rarely thyroid neoplasia. For dogs
on
thyroid supplement, acceptable 4-6 hour post pill total T4
concentrations generally fall within the higher end or
slightly above
the reference range.

7/12/2017 L KL Immunology results from IDEXX Reference


Laboratory Requisition ID: 105665235 Posted Final
Test Result Reference Range
COCCI IGG NEGATIVE
COCCI IGM NEGATIVE
IMMUN DIFF NOT INDICATED
Ascn: 7901201384
RE: 281 HEMOLYSIS INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
Ascn: 7901201384

7/12/2017 L KL Microbiology results from IDEXX Reference


Laboratory Requisition ID: 105665235 Posted Final
Test Result Reference Range
OVA&PARA
Ascn: 7901201384

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 18 of 19 Date: 8/29/2017 8:38 AM


Patient History Report
Client: Prado, Jason (4591) Patient: Lucy (8601)
Phone: (832) 231-5124 Species: Canine Breed: Corgi
Address: 20261 N. Herbert Ave., Age: 12 Mos. 2 Wks. 5 Sex: Female
Days
Maricopa, AZ 85138 Color: Sable

Date Type Staff History

RE: 281 HEMOLYSIS INDEX N


Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
RE: 282 LIPEMIA INDEX N
Index of N, 1+, 2+ exhibits no significant effect on
chemistry values.
Ascn: 7901201384

OVA & PARASITES


NO OVA OR PARASITES SEEN
In cases of acute or chronic diarrhea in addition to a fecal
floatation and
antigen testing for ova and parasites consider testing for
viral, bacterial and
protozoal infectious agents using RealPCR (canine diarrhea
panel: test code
2625; feline diarrhea panel: test code 2627).

B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates,
I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended,
R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs

Maricopa Animal Hospital Page 19 of 19 Date: 8/29/2017 8:38 AM

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