Change in Treatment Plan
Date: ____________Your pet's condition has changed, making it necessary to alter the treatment plan.
Medication
Please use the following medicine dosage and schedule.
_____________________________ Give _________ capsule(s) /tablet(s) / drop(s) / dropper(s) /ml every__________________ hours.
_____________________________ Give _________ capsule(s) / tablet(s) / drop(s) / dropper(s) /ml every__________________ hours.
_____________________________ Apply ____ drop(s) / dropper(s) /ointment in _____________
__________________ times daily/every ____ hours.
_____________________________ Apply ____ drop(s) / dropper(s) /ointment in _____________
__________________ times daily/every ____ hours.
_____________________________ Apply ________________________________________.
_____________________________ Inject ____ units / ml of insulin at ____ AM/PM and at ____ AM/PM.
Feed 1/3 of the daily amount of food or _________________________
at the time of injection. Feed the remainder of the food at _______
AM/PM.
Other directions:
Diet
____No changes are needed at this time.
____Feed the following diet: ______________________________________________________
____Feed ____ cups / cans / ounces ____ times daily.
____Keep fresh water available at all times.
____Furnish ice cubes to lick throughout the day instead of water. Offer free access to water in __________ hours / day.
Exercise
____Allow normal exercise.
____Exercise on leash only.
____Restrict exercise (no stair climbing, jumping, running, rough play) for _________ days.
____Limit exercise as follows: _____________________________________