C09973755 / invoice 10000

Diagnosis: cough - open suspect DAD underlying - early Subjective: - cough mostly resolved after weekend and seems back to normal now - O still would like to pursue chest rads to investigate if anything to prepare for ongoing Treatment: Sedation  : torb/dexdom IM ========================================Radiographic report: lateral + VD thoracic radiographs- trach diameter consistent, no obvious narrowing - VHS 11.3 (acceptable for pomeranian, up to 12 normal) - lung fields ok- heart otherwise ok Assessment: still cannot entirely rule out DAD/collapsing trachea if cough recurs/persists, consider referral for fluoroscopy vs pred trial/flixotide puffer Otherwise chest rads clear for any obvious pathology Conversations: Owner called by:     At time:   Discharge booked?:Plan: monitor cough ongoing     Vital Signs    

Appointment Notes: Trachea issue - User: Dr. Hanson Tan Original Appointment Type: WEB - Consultation - 1. HansonDiagnosis: DAD/collapsing trachea vs other upper airway concern--------SUBJECTIVE:--------Owner reports:- has still been coughing on and off since last visit but not terribly so until this week- on monday evening was really excited and then he had a really bad episode, couldnt really stop and seemed to be stressing quite a bit - coughing more - seemed to struggle to breathe at times too - otherwise has been well in himself and has settled since Appetite: normal Diet: mixed Drinking: nadUrination: nadDefecation: nadDesexed: YWorming:HWP:Flea prevention:Other medications: none---------------OBJECTIVE:---------------Mentation: BAR, FAS 2 Eyes: nadEars: nadOral Cavity: grade 1-2, pink moist mm, crt < 1.5 Thoracic Exam: gen clear, lung fields OK, no dyspnoea, cardiac ok no murmur- mild trach pinch positive Lymph nodes: nadAbdomen: nadReproductive:Skin / Coat: nadFlea Comb test: -ve Perineal / Ag's : nadRectal Exam ( > 7yo) :Gait / Extremities: nad------------------ASSESSMENT:-------------------suspect DAD/collapsing trachea vs other URT concern recc chest rads + airway exam under sedation Treatment: none today ---------------------PLAN:--------------------chest rads booked next monday     Vital Signs    Weight: 4.8;