C09987645 / invoice 10000

Reason: Anal Glands / ArthritisAppointment Notes: checked ab.Paws App Details:Booking Type: ConsultationBooking Notes: Anal glandsArthritis check upHistory: AGs usually need to be manually expressed every 3-4 months Has just started scooting again Seems stiff and sore right after getting up after laying down for long periods Warms up out of this and tolerates walks very well Otherwise well, no further concerns Current Medication: none Examination: Demeanour: BAR, lovely boy. Likes treats BCS: 3/5HR/PR: 68. No murmur or arrhythmia, pulses strong and synchronous RR/Chest: 20. Normal effort and BV sounds MM/CRT: pink, moist/1.5Oral/Teeth/Gums: stage 0-1 dental disease Temp: not taken Ears: external pinna clean Eyes: nad LNs: SM, PS, P wnl Abdo/GIT: soft and comfortable U/G: not assessed M/Skel: ambulating well, mild muscle wastage over hindquarters Neuro: mentation appropriate, no obvious deficits Derm: good coat quality, no lesions noted AGs expressed by nurses Problem List:1. Presumed OAA: history and physical exam findings very suggestive of this. Recommend NSAID trial which O is keen for. Given age would be good to have bloods done first primarily to assess renal and hepatic parameters - O consentedP: await CWP results - if all good can dispense 2 weeks of NSAIDs to trial, and consider long-term use if responding well2. Low HRA: has always had a low resting heart rate though not as low as today. Likely not clinically significant - recommend monitoring for nowP: monitor    Vital Signs    Weight: 26;