C09974693 / invoice 10000

Reason: C5 Vacc And BeransaAppointment Notes: Running15 minutes late ------- Sms reply: YHistory:Due for Beransa as wellCurrent Medications - BOVA Trilostane 100 mg/ml x 0.15 ml BID for HyperAMetacam oral once per week on Tuesday nmight before she works at school on WednesdayVaccination Hx: Due for 3 year C3 and KC INWorming/Flea/HW: monthly Simparica TrioDiet: Supercoat low fat 8% (either sensitive or senior)Environment:Inside/out/schoolConcerns:noneInsurance:Examination: Behaviour/attitude – normalChanges to elimination - NilChanges to noise responses - NilChanges to owner leaving/separation - NilEyes - size/position normal, no discharge, senile nucleosclerosisEars - normalNose - normalOral cavity - normal, some wear, cleanTracheal palpation - normalCardiovascular - no murmur, normal rhythm, synchronous pulses Respiratory - normal bronchovesicular sounds, depth/effort normalAbdomen - symmetrical, no distension/pain/displacement/mass detected Lymph nodes - WNL’sMammary/genital - normalJoint & gait – BOTH ELBNOWS ARE ROTATED OUT SLIGHTLY; PAIN ONM EXYENMTRSOIOPM OF r SHOULDER.HIPS ARE ok EXTENSION rom BUT hl HAVE SOME DEGREEE OF SARCPAENIA.Neurologic – general observations normalRectal - not performedSkin - lipomas x 4 fund lateral thoracic wall each side and 2 ventrallyAssessment: Fit for vaccination todayTreatment: Vaccination Vangiard C4 (B.00306 Exp. 11/27)Vaccination Vangiard CCi (B.03405 Exp. 12/27)BeranSA 15 MG/ML INJ scD/s MORE METACAM (1.43 ML sid AS REQUIRED).Plan: Diagnostics:Therapy options:Estimate:    Vital Signs    Weight: 21.5;       HeartRate: 120;       DentalGrade: 1;       RespirationRate: 24;       CRT: <1.5;       MMColour: pink;       Temperature: 38.1;       BodyScore: 4.5/9;