C09989978 / invoice 10000

Have reminders been checked? Has the owner been advised of this? Hx: V+ on and off the last few months. After these events seems flat and lethargic. Not as excited in food anymore. V+ twice this morning. Will sometimes growl at O when she touches his belly. Has been going to Q store for bloods and last done 1 month ago but unsure results. Not a known foreign body eater. EDDU well and no coughing, sneezing, vomiting or diarrhoea. Diet: Low fat dry + chicken + rice Prop: None Meds: None1Exam:Eyes/ears: No discharge noted. Eyes clear.Oral: MM pink and moist. Build up starting to form on most teeth. Cardioresp: No murmur or arrhythmia. Lung sounds clear.Integ: Coat in good condition.MSK: Ambulating well, no pain on joint palpation, good range of motion.Abdo: Comfortable on palpation. Questionable thickening over the caudal abdo. Plan: DDx: Gastro vs IBD vs addisons vs parasites vs neoplasia vs inflammation vs infection vs other Discussed with O possible causes. Would recc a ultrasound to investigate thickening. Booked for Thursday. Discussed cortisol + CPL testing as well pending bloods from Q store.

O called asking for us to give an estimate of getting abdominal ultrasound. Advised we would need a consult cause the vets may determine that might not require a U/S. O said she wants to do it anyway as she believes theres an abdominal issue. O inquired about price and I gave a rough estimate and stated she would need to pay a consult fee with that anyway. She then wanted me to send it to her insurance to do a pre gap approval, however i stated I would talk to a vet first to see if it was possible. O hung up whilst on hold however spoke to SB who confirmed we would need to do a consult first to determine pre approval as need to fill out questions

Have reminders been checked? Y/N VaccHas the owner been advised of this? Y/N NoGapOnly claim Insurance SummaryFirst Clinic Signs: Recheck after EKT, ongoing infection. Shaking head againDiagnosis/Suspected: No findings on swab, ear infection resolvedSummary/Suspected Cause: No findings on swab, ear infection resolvedAny other conditions being treated/known health concerns(if any): NoTreatment/Plan: Ear swab, clean ears at home, C3 triennual vaccinationPresented for ear recheck. Has started shaking head again recently. No water/liquids in ears since last dose. Forgot to give tablets, has 6 left over - steroid course incomplete. Unsure if has epiotic at home but was using in past to clean ears. Consented to C3 triennual. EDDU, no vx/dx. Did have a small Vx recently after kangaroo meat. PE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM.  Eyes: Bilaterally symmetrical,  clear and no presence of discharge Ears: No erythema or discharge noted, R-ear mild brown discharge on swab. TM intact, NAD otoscopyIntegument: NAD GIT Palpation: Abdomen comfortable on palpation, no obvious massesAssessment Cytology - bilateral debris. Ear infection resolved. Discussed returning to epiotic ear cleaning routine. Briefly discussed cortavance if Rx infx. Treatment C3 SQ - due 17.9.28