C09983284 / invoice 10000

Reason: Check Up Including TeethLicking vaginal area a lot, discharge from eye that smellsHistory:Presenting problem(s) – Both problems noticed 3-4 weeks ago. Tear staining smells funny after swimming at beach. Also seems itchy and licking at vulva, on and off every other day, not a consistent problem. No scooting. Medications – NEnergy levels/ability to exercise – Normal Appetite/diet – Normal, on puppy kibble still as prefers smaller biscuits, cooked meat and cheese to entice (fussy eater).Thirst – NormalV+/D+ - NUrination/defecation – NormalFlea/worm/heartworm – up to date, simparica trioVaccination – Up to dateExam:Demeanour = BARMM/CRT= pink, < 2 secEyes = Tear staining inner corner both eyes, does not smell to me, no signs of inflammation of skin or conjunctivitisEars = NADOral = Grade 2/3 dz on canines but rest of teeth normalChest Auscultation = NADAbdominal Palpation = NAD but tense as slightly nervousLN = NADMSK = NADSkin = NAD, skin around vulva normal. NAD on vaginal cytology, odd neutrophil.O also worried about slight swelling where umbilical hernia used to be, feels like scar tissue, not an obvious repeat hernia at this stage - montiorAssessment: Dental dz on caninesTear stainingTreatment:Recommended dental within next 6-12m for canines, after this could try implementing water/food additives or oral wipes for canines. Will not tolerate brushing. Recommend trying cleaning tear staining with wipes daily.    Vital Signs    Weight: 9.8;