C09983304 / invoice 10000

Appointment Reason: 1.4 CONSULT 4, Appointment Notes: not himself,  breathing strange kmc**S** Hugo 9yo MN Dachshund Presented for breathing difficulties  - has been coughing overnight and seems to be trying to breathe heavy non productive cough. no nasal dischargehas been utd with vacc and preventativeshad KC before but this seems different has been eddu wnl no v+/d+was fine a few days ago for vaccination- PREVENTATIVES: utd with vacc and preventatives - DIET: dry adult biscuits - no change in diet - MEDICATIONS none**O** Demeanour : barFAS: #INPUT# MM : pink, crt<2Dental disease: 2 /4 Calculus, 2/4 Gingivitis - Overall -> 2/4 Eyes: clear and clean bilat, no discharge Ears: clear canals bilat, no discharge LN: soft and wnl HR: 116, ssfp, no murmurs or arrythmias,  RR: increased lung sounds bilaterally, panting, possible crackles auscultated over left ventral cranial lung fields Integ: no significant findings MSK: ambulating well in consult, full ROM in hips and stifles, no pain on palpation of spine abdo palp: soft and comfortable on palpation BCS: 4.5/9Temp: 39no cough on tracheal palpation **A** - ddx - lower resp tract disease ( pneumonia vs pulmonary oedema vs other) vs URT disease ( infectious tracheobronhcitis vs other) **P** Client Communication / Options Discussed with Owner  rec. sedation and xrays vs medical therapy. O okay to admit and do thoracic xrays today. to include Upper airways as well. est given ( 700-800) RWaddendum - sedation - 0.3mg/kg methadone + 10mcg/kg medetomidine IM lat and VD views of thorax - no pulmonary changes evident, VHS of 10.4ddx - suspected URT disease so treating with a cough suppressant 2.5ml linctol orally BID to TID for 3-4 days. Revisit INI within 5-7 days RW    Vital Signs