C09986792 / invoice 10000

Appointment Notes: Booked Online: 18/02/2026 20:44:47 PMBooking Type: VaccinationOwner Name: Sara Clunies-Ross LiauOwner Email: saracluniesross@gmail.comOwner Mobile Number: 0424665464Pet Name: GizmoPet Species: DogWeb BookingClient name: Clunies-Ross LiauContact number: 0424665464Email address: saracluniesross@gmail.comPatient name: Gizmo  ------- Sms reply: Y--- 04/03/2026 11:58:24 TIH:Recently started getting itchy again, about due for cytopointO noted lump/pimple along back, not bothering him, no change in sizeVaccinations: KC/para dueParasitides: NGS, utd + ParaguardEduf normalDiet: PetsO chicken/turkey kibble + Hills dental kibble (3-4 biscuits AM)Schedule: <1/2 cup AM + PMSeems more restless recently, potentially less walkingLots of barking & crying when triggered, gets set off by dog down the roadSet off by any sounds and changeCalmer when he can go up and sniff other dogsNil separation anxiety according to O, not good in car (cries constantly)Medication: nilReason: History:Presented for vaccination, Cytopoint booster and general health check. Owner reports a small lump on the back. Owner also has concerns regarding a recent increase in reactive behaviour. Reports increased barking, crying and unsettledness over the last few months, appearing stressed and frantic. Triggers include sirens, motorbikes, and another dog in the neighbourhood, but can also be unidentifiable. This behaviour has worsened recently and is now occurring in the car. Calming measures such as being placed in a quiet, dark room are becoming less effective. This behavioural change may have coincided with moving to a new house.Preventatives: Cytopoint injection due. Last administered in November.Examination:HR: 140bpmRR: pantingBCS : 3/7Mentation: BAROral DS: 1/4, MM pink and moist, CRT <2s. Teeth appear in good condition however very head shy so best to assess while feeding a treatEars: bilaterally clear external ear canals. No obvious discharge noted, no erythema or swelling noted. Full ottoscopic examination not performed (examined while wandering around consult room)Eyes: Bilaterally clear of weeping or discharge, conjunctiva pink and healthy, PLR intact, able to navigate the room well, full ophthalmic examination not performedCardioresp: no murmurs or arrhythmias auscultated, bilaterally clear lung soundsGI: comfortable and palpable on abdominal palpation. No masses or organomegaly palpatedUrogenital: no abnormal discharge or swelling seenSkin: good coat coverage overall. A tiny, palpable intradermal nodule was noted on the dorsum. It is not raised, red, or alopecic. No obvious areas of pruritis or erythema noted on physical examination. No other raised nodules, pustules or masses palpatedLymph nodes: sub mandibular, pre-scapular and popliteal lymph nodes palpate normallyMusculoskeletal: able to rise and ambulate normally, good ROM in all limbsNeuro: appropriate mentation, full neurological examination not performedBehaviour: Anxious but cooperative during examination. Distractible with food.Assessment:- Annual health check and vaccination.- Allergic dermatitis, managed with Cytopoint.- Reactive/anxious behaviour of unknown aetiology.- Small, benign-appearing skin nodule.Treatment:- Kennel Cough oral vaccine administered.- P2i vaccine administered subcutaneously.- Cytopoint injection administered subcutaneously. He was reactive to the second injection despite cheese treat to distract.Consent has been given by the client to proceed with this treatment - YesPlan:- Advised owner to monitor for post-vaccination side effects such as lethargy, local swelling, or facial swelling. Lethargy for 24 hours is normal; any other signs warrant a call.- Advised owner to monitor the skin nodule for any changes in size, shape, or colour.- Discussed behavioural modification strategies. Recommended the "All Pets Education and Training" website as a resource for understanding and managing reactive behaviour, separation distress, and creating calmness.- Advised on the principles of redirection and retraining attention as a first-line approach before considering anti-anxiety medications. Explained that medication can be a training aid if required but initial management should focus on behavioural techniques.- Next vaccination due in 12 months for kennel cough.    Vital Signs    Weight: 7.9;