C09980042 / invoice 10000

Presented for -  AG expression
presented for nurse Ag expression
done by vet short of nurses today
AG's infected- purulent material expressed, difficult both sides and full. has been scooting and irritated by bottom
O's trialling delicate skin food
Current medications: pred prn for skin
Parasite control: 

Mentation: BAR 
EDUF: nad
Diet: delicate skin
MM: pink moist
CRT: < 2sec
HR:  reg murmur 2/6 100 bpm
Chest Auscultation: normal bronchovesicular
Abdo Palpation: soft
BCS: 5/9
Rectal Exam:  bilateral AG's full, hard to express
Skin: some crusts dorsum
Joints/Gait: ambulates well
Urogenital: nad
Vaccination status:
 
Problem list: 
1) AG infection
2) grade 2/6 L side systolic heart murmur
DDx:

Treatment in clinic: AG's expressed

Plan: sedation AG flush and AB's booked wednesday (O shift worker- best day for them)

Communication: discussed with O can trial oral AB's but often need AG flush and AB into area, O keen to wash out. discussed will need 2-3 repeats 2 weeks apart.

Reason: anal gland expression

Taken to tx room. Both glands extremely full and quite hard to express.Emptying very slowly. Strongly recommended RV in 4 weeks and to introduce psyllium husk and/or glandex chews to prevent any infections occurring. 

ST Emma
- seems back to normal self, using doggy door again. Ok to stop meloxicam
- rash has not returned since starting Z/D 
- still early days but if stays good on Z/D diet trial, can try rechallenging in 6-8w 
- O happy with plan