C09981970 / invoice 10000

HISTORY: History: Owners report EDUF all OK. Has been scooting 

Physical Exam
BAR 
mm: pink, moist, CRT <2s
Eyes: wnl
Ears: wnl
Dental/mouth exam: mild/mod tartar
Lymph nodes: wnl
Chest auscultation wnl, normal resp effort, HR  116 , RR panting
Abdominal palpation wnl, no pain or masses
Musculoskeletal: wnl
Skin: wnl
Nails:wnl
BCS:  2.5/5
Temp: not taken as painful around back end
Swelling L side anal gland on exam, expressed glands and swelling burst revealing bloody purulent discharge. Didnt express R side as too painful after this, to do next visit

Ddx: L anal gland abscess
Tx: meloxi/clav 
Plan: rpt expression 1 week

HISTORY: Owners report BAR and EDUF normally. No health concerns. O has been having issues with her anxiety. She is not left at home for very ong on her own, but when she is left longer than an hour she whines/cries until someone is home .She is also very bonded to Mr and Mrs, and will often get upset even if childern are home (adult children). She has also started to whine in the car, which she never used to do. Owner takes her everywhere with her normally. Has a trainer, owners have been able to extend how long they can leave her with treats/toys etc but feel she needs something else to help calm her. Has already tried zactin

Eyes and ears wnl, mm pink and moist, CRT <2s, dental grade 0-1/4 , chest auscultation wnl, HR 116  , RR panting, abdominal palpation wnl, no pain or masses. Coat good, BCS 3/5, Temp not taken
Discussed medication options, fluoxetine vs neurontin - adv neurntin can be used situationally, rather than everyday, wheras fuoxetine needs to be given sid (although some reports eod works well for small dogs) but cant stop
O elected to trial neuronti  first, sugg 1/3 to half a capsule as required to settle, sugg do some trials at home ith this and trials with owner away for a night with daughter to perpare her fr when they are away for 5 days later in the year
INI OK to trial zactin
WEIGHT: 3.10

HISTORY: Owner called - small amount of fresh blood. D+ less frequent but still present. Owner eports not eating full meals but is eating small bits of chicken breat when hand fed. Semms birghter inself.

Offered hospital for IVFT again als0 offered to send faecal sample - owner delcined both opstions at this point.

GG dx Lectade and Digesticare to trial.