C09978710 / invoice 10000

Appointment Reason: Admit for surgery, Appointment Notes: dental + investigate gum lesion + remove cyst on head - SN  ------- Sms reply: Y    Vital Signs    

Appointment Notes: KCPresented for vaccination todayPhysical examinationHR 124, normal heart soundsRR 28, MM pink, normal hydrationOral examination - grade 1-2 however has a gum lesion on the right mandibular side - potentially hyperplasticity vs neoplastic lump. Recommended to explore this.Ears normalEye examination normalSkin and coat normal - small skin lesion on the left base of the ear - skin tag - only sebum obtained from the lesion. Currently measuring 2mm in diameter and raised by 4mm. Could remove under same GAAbdominal palpation normalMobility normalLymph nodes palpate normallyAppetite and stools normalDiet: commercial and a few bits cooked at home, treatsAdministered nobivac BB/Picurrently on simparica trio and happy with itwill send an estimate for dental scale and polish.for surgery  to remove the skin tagfor potentially sending off histopath of the gum lesion    Vital Signs    Weight: 6.2;       

Appointment Reason: Seizures / Epilepsy, Appointment Notes: seizuring? possibly ate a grape? SN Alfie may have eaten a grape this morning - owner saw him sniffing at it and then it was missing - he then had an unusual episode of lameness/ataxia? On presentation, Alfie was BARHR - 120RR - 24mm - pink and moist and CRT < 2Abdominal palpation is NADLymph node palpation is NADRepeatable pain on back palpationDiscussed the possibility of two issue - grape ingestion? and back pain vs epilepsy but no post-ictal issues?Owner consented to making Alfie vomitApplied 3.25 mg apomorphine to the left ocular conjunctivaAfter 10 minutes emesis induced - vomited 5-6 timesNo grape foundAdministered 0.7 mls metoclopramide (5 mg/ml) SQLeft eye was flushed and ocular lubrication was placedStart on 6 kg dog dose of meloxicam with food SID if requiredI did discuss the possibility of hemivertebrae with corkscrew tailed-breeds and the possibility of disc herniation and paralysisI also discussed how Boston terriers can be predisposed to epilepsyIf owner notices any paresis or paralysis then seek vet intervention immediately - may require examination at a specialist centre for further work-up/advanced imagingI stressed the importance of cage rest over the next week to owner1:00 pm VN SN called owner to see how Alfie was doing - owner reports that he is running around the backyard fine - has eaten and had meloxicam - VN SN stressed the importance of rest    Vital Signs    Weight: 6.8;