C09980930 / invoice 10000

Reason: Any- Coughing IntermittentlyHISTORY:Pepper Yoo presented for follow-up regarding previous skin condition on chest and new onset coughing. Owner reports feeding twice daily since yesterday has resolved scavenging behaviour. Skin lesion on chest persists but owner believes Pepper Yoo is no longer bothered by it. Coughing commenced yesterday afternoon, initially once to twice hourly during day, progressed to continuous coughing overnight resulting in minimal sleep for household. Episodes accompanied by gagging and vomiting white material. Owner reports low energy levels for past few days, initially attributed to workplace visits but now concerned may be illness-related. Pepper Yoo continues regular activities including dog park visits, new locations, and workplace attendance.EXAMINATION:Demeanour/Behaviour: BAR, accepting treats, gentle temperamentBody Condition Score: 5/9Eyes: no discharge or erythema bilaterallyIntegument/Ears: Skin lesion on chest persisting from previous infection, ears showing no discharge bilaterallyLymph Nodes: lymph nodes symmetrical and not palpably enlargedOral: no gingivitis or calculus notedCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeAbdominal: no detectable pain on abdominal palpation, no distension organomegalyNeurological: full neurological exam not done todayPROBLEM LIST:1. Acute onset coughing with gagging and vomiting2. Lethargy3. Resolving skin infection on chestDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:1. Kennel coughDIAGNOSTICS:Temperature normal. NoneASSESSMENT:Young healthy social dog presenting with acute onset coughing, gagging and vomiting white material following recent exposure to multiple dogs at parks and new environments. Normal temperature and clear thoracic auscultation. Clinical presentation consistent with kennel cough given social exposure history and typical symptoms.TREATMENT:Codeine prescribed as cough suppressant. Start with half tablet twice daily, may increase to one tablet twice daily if needed for stronger dose. Continue until coughing resolves, typically four to five days, then wean off gradually. Honey and lemon may provide additional throat coating and comfort but may cause mild gastrointestinal upset.PLAN:Isolate from other dogs for one to two weeks due to contagious natureAvoid contact with young or immunosuppressed dogs particularlyMonitor response to cough suppressantReturn if condition worsens or fails to improveCLIENT COMMUNICATION:Discussed kennel cough diagnosis and contagious nature. Advised isolation from other dogs especially puppies and young dogs for one to two weeks. Explained condition is not contagious to humans but spreads between dogs via aerosolised transmission. Reassured that vaccinated dogs can still contract kennel cough but typically experience milder symptoms. Advised hand washing after contact before handling other dogs. Discussed supportive care approach rather than antibiotics unless systemically unwell with fever or significant illness.    Vital Signs    Weight: 14.5;       Temperature: 38.7 ;