C09978278 / invoice 10000

Reason: General Health Checkup SmtHistory: Brought in by: LesleyNeeds more acular eye drops (script)OA - on CBD oil, paracetamol (didn't get the munchies on CBD) not wanting to eat at meal times, zonked on the CBD oil, when missed had his happiest day (yesterday) but then today has become much flatter, back legs splaying, Insulin - protophane 0.08mlLost 500g since Jan, Eating a reasonable amount. Eats around midday. Couple of spots of blood on poo - Hx of colitis, form been pretty good for him, soft but shaped, No further seizures.Drinking quite a bit - but hot, not noticed a big increase in urination, Examine: On walk in hind legs are splaying and the left hind foot is draggingO has noticed left front leg is twitchingProprioception is normal, L shoulder and L hip both have muscle wastage, No murmur. Both ears are upright now - this has started after beransa stopped!Laboratory: BG 4.3 (1 hour after insulin, not eaten yet)Laboratory:  URINE USG 1.040, pro 1+, glu 2+, bld 3+, rest neg/normalAssessment: Diabetes - adequate control - not to increase dose, disc toujeo, but o not keen to change insulin now.Mobility - OA, but poss neuro effect on LHS body? Muscle wastage?Pain relief - increase paracetamol to TIDCBD oil - trial lower start dose 0.1ml BID for 2 weeks, will need to increase as tolerates aiming for 0.2ml BIDReconsider beransa - but concern re neuro effectsQoL is good at the moment, Neuro investigation - CT?Plan: Paracetamol increase to TID, maintain insulinRestart CBD on lower dose. Monitor weight, see if regains. 2026-2-25 8:52:29			  PRESCRIPTIONPatient Details:Name: PonyoSpecies: Dog Breed: Australian TerrierDOB:11/06/2011 Age:14y 8m	Client Details: Mrs Lesley Hellig36 Mill Hill Road  Bondi Junction NSW  20220432 843 849Prescription:Drug: Ketorolac 0.5% drops (5ml)Dose: apply 1 drop twice daily to both eyesAmount: 1 bottle (5ml)Repeats: 15Notes: For animal use onlySigned:____________________________________Veterinarian: Dr Tony Knapp BSc Hons, BVSc, MRCVS N10070    Vital Signs    Weight: 9.4;       MMColour: p&m;       HeartRate: 120;       BodyScore: 2.5/5;       DentalGrade: 2-3/4;       CRT: <2;       

Meds dispensed. Meds in sharps container behind meds box. SC    Vital Signs