C09979223 / invoice 10000

WEIGHT: 6.10
CLIN_EXAM: BAR. Pink mms CRT 1sec. Dew claw on RHS fore torn - hanging on only slightly but v sensitive to touch
Eyes ears WNL Teeth gr 3-4/4 premolar RHS upper significant disease and gingivitis - showed o
Heart and lungs sound good
ABdo full slightly distended but soft and comfortable
WORMED: N
NN_CHK: N
HISTORY: Nails long and are trying to get cut and now one has flipped the other way
RHS dew claws
EDDU normal
No other health concerns
Transitioning to raw diet (premade) from kibble to try to help with weight loss - doing slow transition
No vaccinations since pup and o doesn't want any - has had previous dogs with seizures
Is on monthly worming and tick and flea.
HEART: 120
TREATMENT: Advised dental - o concerned re GA and costing
Advised sedation for dew claw removal and all nails trimmed - o agreed.
Advised will estimate for dental and discussed staging and all monitoring and blood testing safety prep and o is more comfortable and doesn't want Peppa to be in pain Will send to insurance for pre-approval and if good can go ahead today.

HISTORY: vav for nail procedure

sedation 0.24M and dom 0.06 IM
heavy sedation chieved
WRMRQ: N
FLRQ: N

HISTORY: Hx: Had since a puppy - no pertinent medical hx.
Came in from the yard this arvo NWB RHL; as soon as got here, she started using that leg again as if no problem.
In the past has been to Killarney Vale vets then EHV but started bringing other dog here & this is the first time needed to see a vet for her for a long time (other than vaxes).
EDUF normal?  Y No V/D/C/S.
Description and duration of clinical signs: This arvo.
Energy levels: Good
Diet: Mince, fresh cooked chicken BID RC chihuahua dry left out all day.
Flea/tick/IW/HW prevention: NGS
Any known health conditions: No
Current medications: No

PE:
BAR
Ears: clean, no discharge
Eyes: clean, no discharge
Nose: clean, no discharge
Mouth: NAD, dental Grade: 1/4 wi mod gingivitis
Peripheral LNs: NAD
Cardiovascular: No murmur detected , no jugular distension, SSFP, mm p+m, crt 1s
Respiratory: Lung sounds clear
Abdomen: NAD, comfortable on abdo palpation
Integument: NAD, no evidence of fleas
MSK: walking normally in consult room; MPL grade 3/4 bilat (R>L)
Neuro: NAD, not fully examined
BCS 8/9

Assessment: Bilat MLPs
Dental dz
Overweight

Treatment:
Meloxicam 0.35ml PO SID wi food for 3d (15ml)

Plan:
Dental (hopefully S+P) in the next 2-3wks +/- stifles rads (est w/in dental month $1080) dept on if conts to have issues wi patella(s).
Must loss weight - advised not leaving food out - take away as soon as leaves the bowl.
WEIGHT: 5.55