C09972411 / invoice 10000

Have reminders been checked? Y- vacc doing today Has the owner been advised of this? YGapOnly claim Insurance SummaryFirst Clinic Signs: n/a - annual vacc and Health checkDiagnosis/Suspected: n/a - annual vacc and Health checkSummary/Suspected Cause: n/a - annual vacc and Health checkAny other conditions being treated/known health concerns(if any): nilTreatment/Plan: annual vacc and Health checkHX:Reminders checked: Y - C5 and desexing - will desex around 18mths-2 yearsNCCsPreventatives: NGS - o happy to continue with thisDiet: Chicken and rice, variety of flavours of a prepared meal (o unsure of name).  Probiotic powder.  has helped immensely with gut health may have sipped stagnant water park - loose stool last 1-2 daysno V+No recet coughing or sneezingExam:OMMs pink CRT 1 secG0 DCChest: no obvious murmurs/arrhythmias, lung fields clearAbdomen: no obvious abnsMSN: no obvious abnsSkin/ears/eyes/coat: no obvious abnstestes nadtx/Plan:C5 Canigen inj s.cNext booster due in 12 months

Have reminders been checked? YHas the owner been advised of this? YGapOnly claim Insurance SummaryFirst Clinic Signs: Dx since saturday, large GIT DxDiagnosis/Suspected: Dietary imbalance vs indiscretion vs ibd vs otherSummary/Suspected Cause: Open diagnosis - suspect dietary imbalanceAny other conditions being treated/known health concerns(if any): NoTreatment/Plan: Gastrointestinal diet R/c + probioticPresented for Dx for 3d. Most nights since saturday has been up a few times to let him out. Faeces have Mucus and are yellow, Soft serve consistency. No blood in faeces. Still eating & drinking. Slightly lethargic. Bit better today. Is a scavenger for plants. Indoor only but is allowed to run free at the park. Also went to dog obedience for the first time - no treats, shared water bucket. No FB's. No medications. No dx since first time, stools are always quite soft, especially in the last 2-3 weeks. Diet: Dry + chicken + rice -> changed to boiled chicken and rice a few weeks ago (poss. coinciding with slightly soft stools) -> gave eggs and Vx afterwards (digested) . Prop: Something monthly utd Meds: None PE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Dentition g1Eyes: Bilaterally symmetrical,  clear and no presence of discharge Ears: No erythema or discharge noted Integument: NAD GIT Palpation: Abdomen comfortable on palpation, no obvious masses MSK: Comfortable on flexion and extension. No lameness noted. No dehydration, temp 38.5, rectal NADAssessment Ddx: Dietary imbalance vs indiscretion vs ibd vs other (parasitic, endocrine, organopathy, etc.)Discussed that soft stools for a few weeks may be due to dietary imbalance, lack of suitable fibre in current diet of chicken & rice. Flareup may be due to something else (i.e., indiscretion) but would recc. changing diet long-term. Treatment Opted for no prokolin as difficult to give -> discussed alternative pre/probiotics and is aware missing a binderGastrointestinal r/c biscuitsSent O links to further nutritional guides as wishing to homecook - goal is to increase fibre intake (pumpkin)Revisit if no improvement __________Hi, Below is further information for creating nutrient complete home-cooked diets. a) Easy recipe guidehttps://www.vngpets.com/pages/feeding-guide-for-healthy-dogs-and-puppiesb) Further information for calorie specific mealshttps://balance.it/recipes Kind regards, Dr. AlexPlan 

Have reminders been checked? Has the owner been advised of this? Presented for limping L-FL. Taken for a run yesterday afernoon, noticed he was limping then . Hopping on forelimb and refusing to place weight. Looked through foot and found no pickles, applied ice to the limb. No vx/dx, no medications, struggled with prokolin last timeDiet: Dry + chicken + riceProp: Something monthlyMeds: None PE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Dentition g1Eyes: Bilaterally symmetrical,  clear and no presence of discharge Ears: No erythema or discharge noted Integument: NAD GIT Palpation: Abdomen comfortable on palpation, no obvious masses MSK: Reduced weight placed on L-FL, resented extention of shoulder, mouthed when palpating bicepital groove, disliked R-FL extension but to a lesser extent. Spine & HL's NAD.Assessment      Ddx: Shoulder pain - instability vs tendonitis vs ocdDiscussed diagnostic pathways with owner. Discussed conservative therapy and exercise restrctionTreatment Meloxicam SID 7dStrict exercise restrction 7d Slow reintroduction to exercise