C09977611 / invoice 10000

Record Entered by: Record checked by:Coco is a 12yo FS Bichon Frise presenting for ACTH stimulation test, echocardiogram, and repeat blood pressure monitoring. Specific history: Presenting for further investigation into newly identified heart murmur last visit and chronic signs of panting, thinning of the hair over ventrum and tail, and possible PU/PD in history. Physical examination:SUBJECTIVE BAROBJECTIVEBWT = 6.3 kg; BCS = 5/9VITALS: HR = 160 PR = 160; RR = pant; MM = pink CRT UTG; T = UTG periph T = warmCVS: murmurs = Grade III/VI systolic L base; arrhythmia = nil; pulses = femoral pulses present and synchronous with HR. Blood pressure = not taken.RESP: normal bronchovesicular sounds in all lung field, normal respiratory effort and pattern. No tracheal sensitivity.GIT:ORAL CAVITY: mild periodontal diseaseABDOMINAL PALPATION: no palpable abnormalities or painUROGENITAL: NAD, no discomfort over palpation of the kidneys. Urinary bladder small and comfortable.NEURO: NAD, appropriate mentation, ambulating with appropriate posture with no vestibular signs, a full neurological examination was not performed.M/SKEL: NAD, strongly ambulatory, no muscle asymmetry, full MSK exam not performed.INTEG: thinning of , no ectoparasites, skin turgor normal.OTIC: NAD, no erythema, no discharge, not malodorous. A full otic examination was not performed.OCULAR: NAD, visual, no discharge or epiphora bilaterally, no blepharospasm, no anisocoria, conjunctiva was non-inflamed bilaterally.NASAL: no crusting or ulceration of the nasal planum, no overt discharge, nose moist.PERIPHERAL LN: palpably normal shape, size and texture.Assessment: 1. Plan: - Pending final cardiology report and ACTH stimulation test- O to monitor mentation EDDU, vomiting, panting, respiration in the mean time.    Vital Signs