C09973847 / invoice 10000

Reason:  Check paw
History: Bodhi has been gnawing at his hind paws the last few days; R more than L. Holding paw up today.
O usually takes Bodhi to Marmion vet but harder to get appointment.
O reported that L ulnar surgery at WAVES last year failed. They feel Bodhi has good mobility and seems pain-free but is permanently on previcox and pregabalin.

Current medications: 
Cytopoint last year.
Previcox
Pregabalin

Examine: 
Mentation: BAR. Anxious but friendly if given time.
Body condition score: 2.5/5
MM:   pink             CRT: <2sec
HR:   100           
LN: NAD
Temperature: NT

Ocular: NAD
Oral/Dental stage: 0
Ears: NAD
Cardiovascular: NAD 
Respiratory: NAD
Gastrointestinal: NAD
Integumentary & lumps (measurement, location): Ulcerated at ventral edge of main pad of R hind paw. Mod erythema at ventral interdigital skin. 
Musculoskeletal: Walking well in consult but clear fore limb deformity. Due to time constraints and Bodhi's need for a slow approach LF not examined today.
Urogenital: NAD
Neurological: NAD

Problem List:
RH paw inflammation DDx insect bite reaction vs allergy vs FB vs other
LF deformity

Treatment: 
Cytopoint 30mg s/c

Plan: 
Advised EB collar or sock to stop Bodhi from licking paw. Trial cytopoint as this has previously helped. Not currently infected. O can bathe with dilute betadine, saline.
Advised rehab consult with Dr SH as o unsure if they should trial Bodhi off meds or be restricting his exercise in any way.

Reason: Nail Trim
Consult Nurse: AG
History:
     EDUF: Can have sensitive stomach
     V#/D#/Coughing? No

Examine:
     General Appearance:
     Body Score:
     Coat/Skin: Has been licking at digit 3 (second from outside) of HL paw, dry scabby inflammation on outside of digit 3. Can't see entry point. Noticed a couple weeks, was raw blister, has healed over now. Not still licking at it like before- now intermittently licking. See pics attached.
     Ears/Eyes: NA
     Dental Stage: NA

Treatment:
Nails trimmed in cons. Very anxious from prev AG abscess trauma. Whale eye, hunched and hiding in cons.
Ok for nail trim but anxious about rear end.
Lots of positive reinforcement and went slow for nails, was ok. 
Loves kanga treats, attempted use of licky mat

Next Appointment: RV with vet for paw INI across week

Reason: AG's 
Consult Nurse: JN
History: Licking bum 
     EDUF: normal 
     V#/D#/Coughing? nil 

Assessment: Had AG's done a week ago but owner has noticed that he has been licking bum again. 
O held in consult room, reactive to glands being done today. 
LHS moderately full, normal contents and easily expressed. RHS very full, thick and yellow contents, hard to express. 
Come back in a week and recheck AG to make sure not infected. 

Treatment: Both AG's expressed