C09985105 / invoice 10000

Appointment Notes: Has been bleeding from bum, is in a lot of discomfort & cant go toilet comfortably - nsHistory: Bleeding from bottom, not herself. Feeding advance lamb diet which is working for stools, have been nice and well formed. Initially went to hypoallergenic but transitioned to this dietExamination: BAR, TPR wnl, MM pink and moistR side anal gland abscess, ruptured Assessment: anal gland abscess, recurrent (12 months ago)Plan: metacam and clav. Recheck in 2 weeks and if comfortable anal gland expression. Glandex longer term, maybe add in some hypoallergenic again.    Vital Signs    

Appointment Notes: Paws App Details:  8.6kg todayBooking Type: ConsultBooking Vet: Dr Gus BraniffBooking Notes: Discuss food types for herVerified: NoHistory:Presenting for: Consultation regarding appropriate diet for a dog with History: of diarrhoeaHistorical Conditions: Previously diagnosed with IBD (Inflammatory Bowel Disease)Diet: Currently on Royal Canin Hypoallergenic diet; client reports dog was previously on this diet without sticky breath issues; client notes the latest batch of food smells differentDrinking/Urination: V/D/C/S: History of loose stools; improved with current dietLifestyle Risk Factors: Other: Client concerned about consistency of commercial pet foods; notes that the dog's stools are smaller and better formed on current dietExamination:Mentation: BARTemperature=38.2, Pulse=92/min, Respiration=20/min, MM=pink, CRT<2sec. Assessment:Inflammatory Bowel Disease - Previously diagnosed, currently managed with hypoallergenic dietPlan:Diet Recs:- Discussed rationale for Royal Canin Hypoallergenic diet - predigested nutrients easier for gut to digest and absorb- Noted Hypoallergenic diet is highly digestible, may require feeding less than other diets- Discussed alternative diet options if client wishes to change from Hypoallergenic diet:  - Supermarket options: Optimum (similar to Advance but with variable formulation), Purina ONE (highest quality supermarket brand)  - Pet shop options: Advance (fixed formulation, better value than Royal Canin), Royal Canin, Eukanuba  - Noted dry food is more cost-effective (4x cheaper than wet food on a kilocalorie basis)  - Mixing wet and dry food can improve palatability and digestibility- Discussed that most pet food companies offer money-back guarantees for palatability issuesAdditional Discussion:- Explained that IBD involves individual food ingredients triggering immune response in gut- Discussed importance of fixed-formulation diets for consistency- Noted carrots are safe as treats- Compared pricing: Advance 3kg ($42) vs Optimum 7kg ($45); Advance offers fixed formulation at higher qualityClient Comms:- Client primarily concerned about consistency of diet formulation rather than cost- Client plans to try Purina ONE as it offers highest quality in supermarket brands- Discussed continuing small amount of wet food with dry food for palatability- Advised client can continue carrots as treats    Vital Signs