C09985829 / invoice 10000

Reason: NPC - Bitten On Side By Dog This Morning (AH)Appointment Notes: Site not bleeding, but looks puncturedHistory:Bitten on r shoulder while at park today,On setraline/trazodone normallyExamine:Unable to examine her - too anxious, even just putting stethoscope on chest - turned round as though to biteAmbulatory, can see mms are pink2 x Largish puncture wounds r shoulder area, no blood or pus, not esp swollen at this point - would not allow me to touch the area-visual inspection onlyWould require injectable sedation just to have a close look atNeeds nail clip but would not allow toadyTreatment: Amoxyclav 500mg bid poOnsior 40mg sid poPlan:  RV if area starts to swell, or if purulent d/c seenBack for vaccs in April (adv to give double dose trazodone prior to appt but may requ sedation    Vital Signs    

Reason: Phone Consult Re: Dispensing Trazadone (JP)Appointment Notes: Overdue reminders    Vital Signs    

Phone consult for ongoing medicaitons History:Medication refill for Amy, a dog with sep anxiety requiring TrazodoneHistorical Conditions: History of anxiety requiring behavioural medication managementCurrent Meds: - Sertraline daily- Trazodone 100mg, typically 1-1.5 tablets in the morning, occasionally needed in the evening- Previous episode of urinary incontinence, not currently an issueExamination:Behavioural: Crate training continues to be effective; dog has shown improvement with medication regimenReported to have lost some weightAssessment:Anxiety disorder - Currently managed with combination therapy of sertraline and trazodone; sertraline alone insufficient to control symptomsSeparation anxiety - Improved with current medication protocol; client able to leave dog for periods of timePlan:New Meds/Tx:- Trazodone refill ordered; should arrive Wednesday afternoonChanges to Existing Meds/Tx:- Continue current dosing regimen of sertraline daily and trazodone 100mg (1-1.5 tablets in morning, occasionally in evening as needed)Additional Discussion:- Commercially available Trazodone now being used instead of compounded medication, allowing for quicker turnaround time on refills- Annual checkup due in April; will include sedation, blood testing for medication monitoring, and nail trimClient Comms:- Medication will be available for collection Wednesday afternoon- Annual checkup scheduled for AprilOrdered By (Vet): Medication: trazadone 100mg x 150 tablets x 2 batches Dosage:Ordered: Y/N BOVA Cost (inc GST): $0.00BOVA Ref No: Billed Up (Vet): PLEASE CHECK PRICE WHEN ARRIVESHistory:Medications -Examine:Assessment:  Treatment: Plan:  Estimates given for any procedures discussed.Consent forms signed for all admissions/procedures.    Vital Signs