C09977288 / invoice 10000

Reason: Healthcheck Vax And Arthritis Injection Beransia Appointment Notes: bringing forward vaccines so similar time for arthritis injection History: black mark on tongue noticed a few months ago, not a lump. Not bothered by it, hasn't changed in size.On nexgard spectra for flea/worming, giving drontal monthly.O gives carprofen 50mg 3x/week - needs more as about to expire.EDDU normal.Examination: BARMm pink - limited oral examHR no murmurs/arrhythmiasRR pantingT 38.5Eyes, ears, nose: NADOral: ovoid 0.5cm black pigmented area on the cranial aspect middle tongueLNs: NADAbd palpation: NADSkin: NADAssessment: fit for vxSuspect normal pigmented area on tonguePlan:Pi2 inj SQ and oral bordetella given.Beransa 20mg inj given SQAdvised O doesn't need drontal monthly if giving nexgard.More carprofen dispensed. Advised O can try tapering off if doing well - twice a week, then once a week. Discussed side effects with long term use.    Vital Signs    Weight: 31.7;