C09974920 / invoice 10000

Reason: Beransa InjectionAppointment Notes: 26/2- O would like to discuss with you first, if your think its all good to give today-O mentioned that your were in process of doing a new medication process with/for clover, KJHistory: presented for follow-up assessment after one month of treatment, with owner reporting worsening condition including increased stiffness and weight gain.Current Meds:- Gabapentin - currently taking but experiencing difficulty with capsule form- Meloxicam - Antinol - Cartrophen - discussed as alternative treatment optionDiet:- Free-choice feeding with kibble left in bowl- Increased appetite notedExamine: BCS: Good weight despite recent weight gainMusculoskeletal: Increased stiffness noted compared to previous examinationAssessment: Osteoarthritis - chronic condition showing progression with increased stiffness and mobility issues. Good response to Beransa noted by owner, with clear deterioration when treatment effects wear offPlan: New Meds/Tx:- Continue Beransa  injections - demonstrated efficacy with owner noting clear improvement and deterioration when effects diminish- Continue gabapentin for pain managementChanges to Existing Meds/Tx:- Switch gabapentin from 300mg capsules to 600mg tablets given morning and night (half tablet each dose) - patient has difficulty accepting capsule formulation and tablet form may be more cost-effectiveAdditional Discussion:- Discussed Cartrophen as alternative treatment option but noted lack of safety studies when used concurrently with Beransa - Explained that Beransa  has stronger scientific evidence for efficacy compared to Cartrophen, which has mixed study results similar to glucosamine supplements in humans- Treatment approach remains trial and error, with ability to adjust medications as needed based on response- Owner travelling to Korea and Japan for 3 weeks, picking up larger medication supply    Vital Signs    

    Vital Signs    

Reason: Deshed + Nails Drop @ 12Appointment Notes: Shave paw pads - no grinch feet SCHwill fix up GAP todayAlso needs C5 and HWI - Emily VetcxPerson clipping: Max/SarahStyle and Size: Deshed & part clip - round pants, round feet & pawpads.Shampoo/conditioner: Deshedding, cond, spray, nailsBehaviour: Angel <3SLW    Vital Signs    Weight: 35.6;