C09983259 / invoice 10000

Appointment Notes: * GHC + anal glands please * VETSTORIA - Coco (Dog) - Linda Morris - 0416113137 - Consultation [Clinician : Dr Ainsley Van Egmond (Preferred Clinician)] - Consult  - Web BookingClient name: Linda MorrisContact number: 0416113137Email address: lgm5@bigpond.comPatient name: Coco  ------- Sms reply: Yes?????History:Coco presented for a recheck of her anal glands. The owner reports issues have been ongoing for the last five weeks. The left anal gland is historically more problematic. Coco has been receiving Glandex, which is now finished, but the owner feels it was not sufficient. She is eating and drinking well. The owner has a finger infection, which has made administering some home care, such as parasite prevention, difficult.- Significant history: Recurrent left-sided anal gland impaction.- Current medications: Owner has been giving an "Air-Fiberless one" supplement (half a teaspoon) but has finished a course of Glandex. Parasite prevention is not currently being administered.- Appetite & diet: Appetite is good. Diet consists of oats, pumpkin, carrots, and broccoli.Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperaemia, no epiphora.- Ears: Ears clean, no malodour.- Oral: Grade 1 dental disease. Mild calculus present.- Nose: NAD.- Cardiovascular: No murmurs or arrhythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Normal coat, no ectoparasites.- Abdomen: Soft, no masses palpated.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Right anal sac contained a small amount of material, expressed easily. Left anal sac was enlarged, impacted, and painful on expression.Assessment:Problem List:* Left anal sac impaction, recurrent.* Pain associated with left anal sac.* Grade 1 dental disease.Treatment:Bilateral anal sac expression performed.Plan:* Commence Movicol.* Continue current high-fibre diet.* Recheck anal sacs in one month.* Re-evaluate dental health at next visit.Client Communications:Discussed findings of an impacted and painful left anal sac, noting it was less severe than the previous visit. Advised to start Movicol for improved management and continue the current diet. A one-month recheck for the anal glands was scheduled. Discussed that vaccinations are due in five months. Prognosis is good.?????    Vital Signs    Weight: 8.6;