C09979451 / invoice 10000

Reason: Lethargic And Needy > TK Appointment Notes: Max (Dog) - Vet Consultation [Clinician : Dr Heather Russell(No Preference)] - Lethagic and needy.Web BookingClient name: Katerina KingContact number: 0401609375Email address: dolceverity@gmail.comPatient name: MaxHistory: Owners describe episodes of hiding away and shaking approximately every 2 weeks. Can stare at walls and seem minimally responsive. Opening and closing eyes, twitching. Not related to eating. No known grand mal seizures observed. Has done this for several months Subjective: BAR Examination: HR 100, pink moist mm, crt 1-2 sec, FP normal, RR panting, temp 38.7BCS: 5/9Oral Cavity: Oral cavity is normal. Dental grade 0/4CV: Heart sounds normal. No murmur or arrhythmia. FP strong and synchronous. Resp: Lungs sounds normal. No nasal discharge. No URT stertor. MK: Ambulating normally. No neck or spinal pain. Neuro: Mentation appropriate. Palpebral and menace reflex intact OU. LN: Peripheral LN normal size, shape and consistencyGIT: Intestines soft and comfortable. Rectal: ND Urogenital: bladder small, kidneys symmetrical and normal in size and shape. Integument: Good hair covering, no ectoparasites detectedEars: Canals clean without evidence of infectionEyes: Appear normal OU No pain localised. Video observed - seen to be staring at a wall, opening and closing eyes with ears held back. Appears more than behavioural response. Assessment: Possibly focal seizures vs pain vs behavioural Client Communciation: Discussed ddx - epilepsy, PSS, pain, behavioural. Plan: Recommend start with PAGR and bile acid (fasting)Consider referral to SASH for assessment by specialist (medicine/neuro) and possible MRI if deemed necessary.May require a bile acid stim test (fasting sample submitted)    Vital Signs    Weight: 10.8;