C09971876 / invoice 10000

History:Presenting for C5 and beransa. O reports P doing well - EDDU normally. No CSVD. Beransa injections still helping. Has a few lumps which O reports have been investigated previously as cysts. Starting to lose hearing a bit. O has no concerns today. Current meds: beransa injections monthly and gabapentin 300mg BID. Examine:Demeanor: BARBCS: 6.5/9Hydration: MM pink & moist, CRT <2sEyes: Open and comfortable. Full ophthalmologic exam not performedEars: No erythema. No malodour. No waxy discharge bilaterally. Responds to sound. No history of pruritus.Nose: No ulceration. No crusting. No nasal discharge. Oral exam: 2/4 - moderate tartar, early gingivitis, teeth worn down. LNs: Submandibular, prescapular and popliteal LN small, round, symmetrical. Integument: Shiny coat. No diffuse areas of redness, crusting or scaling noted. Various lumps on abdomen/chest.Cardiovascular: HR = 100. No heart murmur or arrhythmia auscultated. Respiratory: No coughing. No sneezing. Clear lung sounds in all 4 quadrants. Panting.Abdomen palpation: Comfortable. Rectal exam: Full rectal examination was not performed. Urogenital: Not examined.MSK: Ambulating normally - weight-bearing in all limbs. Not favouring a certain limb when standing still. Very stiff gait. Left hind leg hock swelling (previously reported).Neuro: Appropriate mentation. Full neurological exam not performed.Assessment:1. Ok to vaccinate.2. Still responding well to Beransa.Treatment:Protech C4 administered SC in scruff.Protech KC administered PO. Beransa 30mg/ml 0.75ml administered SC in scruff.Client comm:- Discussed if O notices reduction in Beransa effect to see vet to discuss alternative pain management options. Plan:1. C5 next due in 12 months.2. Continue Beransa monthly.  

email:Oreo Richardson. Pic from Nurse Appt 15/01/26 at 10.30am.Left Hind Leg Swelling (already seen by Vet at last re-check appt). Pic is for future reference should changes occur in leg. TG Please add to file.Thank youTarapic attcahedAD 19/01

Grace popped through a gap only for the 8th Jan, benefit wasn't applied and client hadn't paid remaining amount. Confirmed with Gappay and they confirmed benefit amount and that client owed remaining. O was happy to pay remaining on previous visit.