C09984131 / invoice 10000

Reason: AHC + VaccsAppointment Notes: Winston (Dog) - Sarah Pelser - 0451311196 - Annual Health Check & Vaccination [Clinician : Dr. Lauren Drummer(No Preference)] - Annual checks and vaccinations  - Existing client Web BookingClient name: Sarah PelserContact number: 0451311196Email address: sp285285@gmail.comPatient name: WinstonHx: Chewing feet at night. Owner thinks could be behavioural component. Lump left flank still very small. Left cranial nipple enlarged when he was scratching and crusty. Now ok. UTD tick prevention EDDU normal. No breathing difficulties. No exercise intolerance. Shorter walks in summerDiet: kangaroo meatballs, veges, kibble, fresh meat. Previous hx: Previous airway surgery helped. Zenrelia in dec for itchy paws helped at the time. PE: BAR, euhydrated, BCS 3/5, gained 500g, HR 120, RR pant, temp.- EENT: mild wearing upper canines. Tiny tartar overall goodInteg: 0.3cm raised lump left flank brown lump (owner said has not grown). Mild erythema ventral feet esp right fore. Around right fore dew claw erythema, no pain on palpation dew claw, nail bed ok. Sticky tape ventral feet- scant yeast 1/hpf. Lns nadCardio: nadResp: nadAbdomen: nadNo lamenessNormal mentation Assessment: Pruritic paws- atopy, contact allergy with yeast. Ok for vaxTx: nobivac KC SQNobiac C3 SQNobivac lepto SQ Lick matt- does not like needles and wriggly. Inject in neck and matt worked well today. Plan- chlorhex SIW front paws. Monitor right fore dew claw for infection. INB may need allergy meds- briefly outlined allergy injection vs tablets again. Long-term management may flare at various times depending on plants in environment. Dry wet feet.    Vital Signs    Weight: 14;