C09971908 / invoice 10000

Reason: Chronic bronchitisAppointment Notes: Ref Vet have suggested a bronchoscopyIntern DCHistory:Nova is presenting to ARH IM for exercise intolerance, excessive panting and increased resting respiration rate.  Nova was presented to PCV on Jan 2026 for above concerns. Moderately harsh bronchovesicular sounds were noted **Presenting complaint/s and history:**- Presented for investigation of exercise intolerance, increased respiratory rate, and excessive panting.- History of excessive panting for up to 1.5 hours after minimal exercise.- Rapid respiratory rate observed by owner while sleeping.- One episode of near collapse after exercise.- Panting also occurs after drinking water.- No coughing reported.- No vomiting or diarrhoea reported.- No abnormal drinking or urination reported.**Previous medical history:**- Ovariohysterectomy and umbilical hernia repair (May 2025).- Foreign body ingestion (balloon, paddle pop stick) requiring induced emesis on two occasions.- Ear infection (May 2025).- Malodorous anal gland secretions, resolved with diet change (July 2025).- Mild bilateral macroblepharon, more pronounced on the right (incidental finding, July 2025).**Current medication:**No current medications.**Diet:**Changed from 'Scratch' dry food. Currently fed cooked chicken, blueberries, apple, carrot BID, small amount of grated cheese on dinner, and a nightly dental stick.**Diagnostics performed prior to referral:**- Chest X-rays (10/02/2026): Interstitial to bronchointerstitial pattern, particularly in the caudodorsal lung fields. Normal cardiac silhouette. No effusion or pneumothorax.- Bloods (10/02/2026):- Haematology: Mild basophilia (0.12 x10^9/L). Otherwise unremarkable.- Biochemistry: Elevated TT4 (57 nmol/L). Otherwise unremarkable.- Heartworm test (10/02/2026): Negative.Physical exam:**HR:** 124 bpm **RR:** 40 bpm **T:** deferred **MM** pink moist**General Appearance:** BAR, a little anxious, nervous**Hydration:** Hydration appears normal**Body Condition Score:** 6.5-7 out of 9**Thoracic auscultation:** Moderately harsh bronchovesicular sounds bilaterally, most prominent over cranial lung fields. Mildly dulled sounds on caudal fields. No crackles or wheezes. Very mild tracheal sensitivity on palpation, eliciting a small huff. No murmur or arrhythmia.**Pulses:** Normal intensity and synchronous.**Abdominal palpation:** Soft and comfortable. No organomegaly.**Lymph nodes:** No peripheral lymphadenomegaly.**Oral examination:** No overt oral disease.**Ocular/integument/ears:** Clean and clear OU. Clean healthy coat.**Neurologic examination:** Neurologically appropriate.**Musculoskeletal:** Ambulating well, no lameness.**Urogenital:** External genitalia clean.**Rectal examination:** Not performed.Diagnostic tests / procedures:- Plan for endoscopy to investigate for upper respiratory obstruction.Assessment:Exercise intolerance of unknown aetiology. Primary concern is potential for primary pulmonary pathology given history and prior radiographic findings. The possibility of exercise-induced collapse related to a genetic cause in Cocker Spaniels is also considered.Treatment and Future Plan:Monitor and track breathing, particularly after exercise. Proceed with endoscopy and bronchoalveolar lavage to further investigate respiratory signs.    Vital Signs