C09985746 / invoice 10000

Appointment Notes: VETSTORIA - Kobe Coster (Dog) - Siobhan Coster - 0422840696 - Consultation [Clinician : Dr Ainsley Van Egmond(No Preference)] - vomiting overnight (small bile vomits) for the past 3-4 nights. Also needs his vaccinations  - Web BookingClient name: Siobhan CosterContact number: 0422840696Email address: siobhan.coster@gmail.comPatient name: Kobe CosterREASON: vaccinationHISTORY:Owner reports that _ has been doing well at home. EDDU normal. No recent vomiting or diarrhoea reported. Flea/tick/worming:PHYSICAL EXAM: Demeanour: Vitals: CVS: regular rhythm, no murmur, SSFP.RESP: normal respiratory effort, clear bronchovesicular sounds; no crackles or wheezes.ORAL: NAD OCULAR: NADABDO: soft and comfortable to palpate.LNs: peripheral LN WNL.INTEG: coat clean, no visible ectoparasites.GAIT: ambulating well, no lameness observed.UROGEN: NADASSESSMENT: Fit for vaccination today.TREATMENT:C5 (Protech C4 SC + Bronchi-shield PO) administeredProtech C4 administered SCAfilaria SR12 _ ml SC PLAN: - booster in 12 months. ?????History:Presented for four nights of nocturnal vomiting. Onset Saturday night following ingestion of unknown plant material at Newstead Park. Vomitus initially contained plant matter, but for the last two nights has been small amounts of bile. Last night, patient was nauseous and seeking comfort around 2:00 am before vomiting. Appetite and faecal output are normal. Patient seems bright and active during the day. Owner noted an episode of scooting and fibrous material in faeces a few days ago.- Significant history: Intervertebral disc disease (managed with physiotherapy), hip sensitivity, known chicken allergy, recurrent yeast otitis externa, and recurrent pododermatitis.- Current medications: NexGard Spectra monthly.- Appetite & diet: Eating normally. Fed a hypoallergenic dry food for breakfast and dinner, with sardines added to the evening meal.Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperaemia, no epiphora.- Ears: Ears clean, no malodour.- Oral: Grade 0 dental disease.- Nose: NAD.- Cardiovascular: No murmurs or arrhythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Normal coat, no ectoparasites.- Abdomen: Tense and painful on palpation.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Not assessedAssessment:Problem List:- Vomiting (nocturnal, bilious)- Abdominal pain- Giardia infection (positive antigen test)- Vaccinations overdueTreatment:- Anti-nausea injection administered (24hr duration).- Vaccinations: C3 (Distemper, Hepatitis, Parvovirus) injectable, KC intranasal.- In-house faecal Giardia antigen test performed: Positive.Plan:- Antibiotics: 3/4 tablet orally twice daily for seven days.- Antiprotozoal liquid: 7 mL orally once daily for five days.- Continue current hypoallergenic diet. Advised feeding dinner later (6-7 pm) to reduce overnight bilius vomiting.- Advised strict environmental hygiene. Pick up faeces immediately to prevent reinfection. Wash all bedding in seven days at the completion of treatment.Client Communications:- Discussed positive Giardia diagnosis as the cause of clinical signs. Explained faecal-oral transmission and high prevalence in the local area. Advised on zoonotic potential and hand hygiene.- Prognosis is good.- Discussed parasite prevention options. Owner declined yearly injections due to cost and elected to continue monthly oral treatment.- Vaccinations updated as per discussion.?????    Vital Signs    Weight: 14 (Patient Update);       

    Vital Signs    

Appointment Notes: VETSTORIA - Kobe (Dog) - Siobhan Coster - 422840696 - Consultation [Clinician : Dr Sarah Mak(No Preference)] - Back pain  - Web BookingClient name: Siobhan CosterContact number: 422840696Email address: Siobhan.coster@gmail.comPatient name: KobeHistory Kobe presented today for script for meloxicam. Intermittent RPL lameness noticed 2 years ago. Was managed by QVS surgery and had CT in Sept 2023 which showed- Mild dorsal herniation, L7-S1 intervertebral disc – degenerative disease.- Focal osteopathy, dorsal aspect of cranial endplate of S1 – endplate junction failure vs less likely osteochondrosisO has been managing with meloxicam PRN and going for physio. Would like to have more meloxicam today. Exam:Demeanor BART: -            MM: pink and moist P: 96 bpm        CRT: < 2 seconds R: 28 bpmBody Condition Score: 5/9 CV: WNL RESP: WNL EYE: WNL EAR: WNL ORAL: WNL LN: WNL INTEG: WNL ABDO: comfortable on deep palpation  MSK: ambulate well comfortable NEU: mentation normal. CP and withdrawal intact to all limbs. Mild discomfort on lumbar palpation Assessment: L7-S1 intervertebral disc herniation - well managed with meloxicam Plan:Script dispensed as O requested. Meloxicam 1.25mg q24h PO (2.5mg tab - half a tablet SID PO PRN)    Vital Signs    Weight: 13.5;