C09974137 / invoice 10000

Appointment Reason: Fitting/Seizure, Appointment Notes: has had some type of episode? on their way to emergency but prefer to come to us.?????SUMMARY* Presented for an acute, transient episode (~1 minute) of weakness, ataxia, and back arching following a walk. The patient recovered quickly but remained subdued.* Clinical examination was unremarkable. Tentative differential diagnoses include spinal pain (e.g., IVDD), syncope, or a mild seizure-like event.* Plan is to monitor at home. Advised to record any future episodes and return for re-evaluation or proceed with diagnostics (bloods, imaging) if signs recur or worsen.HISTORY* Acute episode of ataxia, stumbling and dorsal arching approximately one hour prior to presentation.* Episode lasted about one minute; patient did not lose consciousness and showed no signs of seizure activity. * Occurred post-strenuous walk (approx. 20 mins later)* Owner noted tachycardia during the event (via palpation of chest when holding Margeaux)* Patient has been subdued since, but appetite is normal (ate treats immediately after the episode)* No previous similar episodes, but does occasionally get nervous "shakes"* Patient is not currently on any medications and has had no access to toxins, human medications, etc. EXAMDemeanour: QARBody condition score: 5/9Ambulation: NormalEyes: Eyes clear, no signs of conjunctivitis, pupils symmetrical and tracking normally.Mucous membranes: Moist, pink, CRT < 2secTeeth: Grade 0/4 perio. Minimal staining on maxillary carnassials.Skin: No unusual masses noted, normal skin tent.Heart: Heart and lungs auscultated. Mild tachycardia noted (nervous in consult). Normal rhythm and sounds, no murmur or arrythmia. Lungs clear.Abdomen: Abdominal palpation normal, no pain or obvious masses identified.Lymph nodes: Normal sizeOther:* T: 39.1°C* Neuro: No neurological deficits identified. Normal balance and proprioception. No head tilt or nystagmus present. * Musculoskeletal: Non-painful on palpation of spine, neck, and limbs. Panniculus response and ambulation all normal. Normal range of motion in neck.ASSESSMENT* Acute, transient episode of ataxia and apparent discomfort of unknown origin.* No abnormalities identified on clinical examination.* Possible differential diagnoses include:* Spinal pain (e.g., intervertebral disc disease).* Syncope.* Focal seizure (unlikely, based on O's description)* Muscular over-exertion post-walkPLAN* Monitor at home.* Offer small, frequent meals (bland diet like chicken and rice if inappetent).* Advised to record video of any future episodes to aid diagnosis.* Offered blood tests for peace of mind, but advised not medically indicated at this stage.* Return for re-evaluation if signs recur, or attend an emergency clinic if after hours.* Financial considerations of deferring diagnostics were discussed.CLIENT COMMUNCIATION* Advised that the physical examination was unremarkable.* Discussed possible causes, including spinal discomfort or over-exertion.* Warning signs discussed: any change in behaviour, worsening symptoms, seizure activity, inappetence, vomiting, or diarrhoea.* Advised to focus tooth brushing on back teeth for dental home care.???    Vital Signs    Weight: 6.1;