C09973090 / invoice 10000

Reason: VaccinationAppointment Notes: KICPatient Information:- Ted- Date of Examination: 02/03/2026Subjective:- Presenting for recheck of oropharyngeal mass.- Owner reports some bad nights.- Restless at night, moving from bed to floor tiles.- Panting associated with humid weather.- One episode of vomiting clear phlegm on Friday.- This was the first time he has ever vomited.- Appetite and weight are stable.- Owner notes he seems thinner over the back.- Increased hair shedding.- History of oropharyngeal mass diagnosed on 10/12/2025.- Biopsy confirmed a tumour.- History of elevated Alkaline Phosphatase.- Currently on meloxicam once daily.Objective:- Weight is consistent.- Examination of the oral mass noted.- Ulceration over the mass appears to have opened.- The tumour itself appears to have grown larger.- It is more prominent externally.- No pain on palpation of the mass or pressure on the eye.- Remainder of physical examination unremarkable.Assessment:1. Oropharyngeal Tumour- Mass is progressing in size.- Ulceration may be providing some pressure relief.- Nocturnal restlessness and noisy breathing likely due to upper airway obstruction.- This is exacerbated by heat and potential stress.- Vomiting episode may be related to swallowing mucus from the ulcer.Plan:1. Oropharyngeal Tumour- Continue meloxicam once daily.- Commence gabapentin for sedation and analgesia.- To be given in the evening with dinner.- This aims to reduce stress and improve sleep quality.- The dose can be adjusted if needed.- A repeat dose can be given after 8 hours if required.- Discussed that gabapentin can be given with or without food.- Dispensed more meloxicam.- Dispensed gabapentin.Additional Notes:- Advised owner to give gabapentin before he becomes distressed.- This is to pre-empt the evening restlessness.- Owner to monitor for any adverse effects like diarrhoea.- Reassured owner that stable appetite and weight are positive signs.- Advised that muscle wasting along the back can be a side effect of previous cortisone treatment.- Plan to re-evaluate in approximately one month, around Easter.- Owner to ma    Vital Signs    Weight: 15.6;