C09972524 / invoice 10000

Reason: D+ And Now Some Blood Present Too - Robyn VetcxHistory:D+ started Saturday. Then Sunday and today noted mucus and blood. Increased defecation fx. Appetite fine. Energy level normal.Did have a bone on last Wed - raw beef bone. Has been a while since he had a bone. Sometime do get runny poo from this but more yellow than orange, in the past.Mon, Wed, Fri - go with dog walker. Unsure if he has picked up something. Diet: RC labrador dry + whatever he scavenges. Last couple of days have chicken/rice/pumpkin. Generally have formed stools. O noted a wart like lesion near his nose - been there for a couple of months, haven't changed. UTD w/ nexgard spectra monthly.Examine:BAR MM pink/moist CRT 1-2sEyes - clearEars - clearDental grade - G0.5/4HR=PR=96 No murmur/arrhythmiaAll lung fields sound clear. Normal REAbdomen soft and comfortableSkin - normal hair coat. Normal skin turgor. Small wart noted on left nose bridge. All peripheral LNs normalAmbulatory - no lameness or ataxia, full ortho exam not performedTemp - 37.9Assessment:- Acute LI diarrhoea with bloody mucus - likely colitis. Ddx: dietary indescretion (raw bone vs others), infectious gastroenteritis, FB/obstruction less likely, extraGI causes. - Hemodynamically and clinically well. - Facial wart on L nose bridge - benign, stableTreatment:- Continue bland diet (chicken and rice)- Pro-Kolin probiotic 6ml twice dailyPlan:- Continue bland diet and probiotic until 3 consecutive normal stools then discontinue probiotic. - Avoid treats during recovery period- Monitor for worsening or lack of improvement -> recc blood, fenbendazole trial etc. - Advise dog walker to maintain vigilance and avoid treats- Recc tapewormer if he gets regular raw bone/meat long term.    Vital Signs    Weight: 31.55;       Temperature: 37.9;       BodyScore: 5/9;       

Reason: Lepto BoosterNo reaction to first Vaccine. Doing well.Very nice dog.    Vital Signs    Weight: 31.79;       MMColour: pink;       Temperature: 38.02;       CRT: 1-2 ;       

Reason: HC + VaccinationsVerified: Yes History: No vomiting, diarrhoea, itchiness, or coughing. Appetite good, eating well. Energy levels good, no mobility issues.Parasite control: Regularly on Nexgard Spectra.Diet: Receives treats and dental chews on top of kibble. Examine: Mentation BAR, MM pink moist, dental grade 0/4, eyes/ ears/ skin/ coat normal, abdomen soft and comfortable, peripheral LNs normal, CV and chest normal, BCS 5.5/9, weight gain of just over a kilo but overall BCS not too bad. Assessment: Helathy. Ideal weight around 30-31kgTreatment: Duramune C4 SC , C2i SC , Bb PO .Plan: Aim for weight of 31 to 31.5 kg, continue Nexgard Spectra, schedule leptospirosis booster in 2-4 weeks.    Vital Signs    Weight: 31.76;