C09983794 / invoice 10000

Reason: GHC/ Dental Check RCAppointment Notes: Overdue reminders  ------- Sms reply: YReason: Name of Client Present:TBC Nurse Initials:Client Concerns:Vaccination: (Type:   Canine cough due Aug 2026Parasite Prevention: (Product Name:   ) (Last Given:   )Microchip # & Behaviour Indicator filled in: YesInsurance / Healthy Pets Plus:insuranceIs patient on any medication? NoCurrent Diet:Product:Feeding schedule:Laboratory Testing Needed:_____________________________________________________________**History:**Presenting complaint: Annual health check, scooting, halitosis.Pertinent medical hx: Malocclusion (underbite).Current medications: None.. Owner reports Scout is eating and drinking well with no vomiting or diarrhoea. Brushes teeth approximately two-three times per week. Looking for a dental check. DUDE normal. No other reported concerns. **Examination:**Mentation: Bright, alert, responsiveTemperature: NT Heart Rate: 80Respiratory Rate: 20Mucous Membrane: Pink, moist, CRT: <2sCardiovascular: No murmur or arrhythmia detected. Femoral pulses normokinetic, synchronous.Respiratory: Normal bronchovesicular sounds right and left lung fields.Body condition score: BCS 5/9Abdominal palpation: Soft and comfortable abdomen throughout.Oral examination: Mild calculus present on canine teeth and carnassials. Malocclusion (underbite) noted. No significant gingivitis. Gr1. Upper incisors do not appear to impinge on opposing soft tissue. Ocular examination: Pupillary light reflexes present and consensual, normal menace responses and palpebral reflexes.Aural examination: External ears clean and free from discharge, otoscopic exam not performed.Integument: No obvious abnormalities detected.Lymph nodes: Submandibular, pre-scapular and popliteal lymph nodes normal size.Urogenital examination: No obvious abnormalities detected.Rectal exam: Anal glands expressed, 1/2 full normal contents. Neurological examination: Normal mentation, ambulatory with voluntary movement in all limbs and tail. Full neuro exam not completedMusculoskeletal: Ambulatory, able to rise and ambulate without difficulty. Normal gait.**Problem List:**1. Malocclusion (underbite)2. Mild dental calculus**Differential Diagnosis:**NA**Diagnostics:**Pre-anaesthetic bloods discussed as an optional screening tool prior to any future dental procedure.**Assessment:**Scout is a young, healthy dog presenting for a routine check. Examination revealed a known malocclusion (underbite) which is predisposing to the early accumulation of dental calculus/dental disease. Overall, currently in good health.Client Communication:Discussed with the owner that the malocclusion predisposes Scout to dental disease. Recommended increasing home dental care to three times weekly. Advised that a COHAT under general anaesthesia would be beneficial to reduce the bacterial load and assess for underlying pathology with dental x-rays thus preventing problems rather than tx when occur. Recommended this procedure towards the end of this year or early next year. Provided an estimate for the dental procedure, including the optional pre-anaesthetic blood test. Estimate provided was $1,013 with bloods, and approximately $800 without. The owner has opted to consider this for early next year. Discussed vaccs due 11/08/26**Treatment:**Anal glands were expressed.**Plan:**Continue to monitor dental health at home.Increase tooth brushing frequency to at least three times per week.Plan for a COHAT in late 2026/early 2027.Revisit if scooting persists or any other concerns arise..    Vital Signs    MMColour: pm;       Weight: 6.5;       Temperature: NT nerous but friendly;       HeartRate: 80;       BodyScore: 5;       RespirationRate: 20;       CRT: 1;