C09990569 / invoice 10000

Reason: Bleeding From Leech LH Appointment Notes: Overdue remindersHistory: owner found leech onground and blood pouring from pups mouthAdvise dto bring in to tcheckExamine: blood blister under tongue, slow trickle of bllod from area.Dog brightTreatment: butorphanol 0.2mg/kg s/c11.45amOnce a little quieter, given 0.4ml of 100mg/ml TXA slow IV.Clot found under tongue near frenulum, still oozing1.30pm no bleedingFedTo go home    Vital Signs    Weight: 4.0;       

Reason: $99  Puppy Consult AND VACCINATIONSHx- BIOP 1 month ago, breeder- only pet in household- EDDU normally,no csvd- Main diet: dry food- scooting, but only after defecating- due worming- 6/1/26 Protech C3- cleaning ears but still dirty, shaking head, scratchingPE- mm pink CRT 1 sec- teeth good- heart sounds fine- temp normal- 2 descended testes- skin/coat fine- LN fine- bilateral mildly inflamed ears, mild brown discharge, cytology yeast ++- NAD rest of examTreatment- Nobivac DHP and BB/pi given SC- NObivac Lepto given SC (#1/2)- nails clipped Plan- 0.3ml dermotic both ears BID 7 days- owner to give simparica trio- back in 1 month for final puppy vaccination and to discuss desexing (discussed delaying dexexing status on registry if owner wishes)Puppy pack givenOwners have insurance    Vital Signs    Weight: 2.9;