C09991133 / invoice 10000

S: Check anal gland abscess noticed yesterday - took to emergency but wasn't able to be seen as too busy there. O hadn't noticed scooting prior. Is still quite bright and eddu ok. O says fussy eater, fed chicken and ziwi peak. Does brush teeth but not recently.O: BAR, mm pink, gd 1-2 tartar present, heart and lungs wnl, abdo comfortable, temp 38.3. Left sided ag normal on expression. Right ag area large firm swelling with central sinus, discharging small amt blood - unable to express. A: r ag abscessP: warm salt water bathing, nsaids and antibiotic combo clav/metrogyl. Rv 7-10 days to recheck and try express r side. Recc restart brushing, ideally dental diets but o thinks won't eat. Will need to consider dental prophy in future.     Vital Signs    Weight: 9.4;       

    Vital Signs    

Appointment Reason: VaccinationHx:- has on and off soft stool and D+ for a few months. Doesn't change his diet- diet: kibble, chicken breast. Gives white rice + chicken breast when he has D+. Sometimes gives lactose free greek yogurt- has good appetite and energy levels- no V+, coughing, or sneezing- parasite: nexgard chew given monthly- no previous vaccination reaction- no other pets at home- O has no other concernsExam:BARHR: 160bpm  MM: pink   CRT <2s  RR: 42Eyes: clear anterior chamber, no dischargeEars: clear on visual exam. Otoscopic exam not performedNose: no discharge, crustingOral: mild tartar especially around canines and molars. G1 dental diseaseLN: palpation of peripheral LN- normal size and consistencyCardiovascular: Normal rhythm, synchronous femoral pulses, no murmurs or arrythmias auscultatedRespiratory: normal bronchovesicular lung sounds, normal effortAbdomen: soft on palpation, non-painful, no masses appreciatedUrogenital: both testicles descended. Normal on palpationIntegument: clean skin and soft coat, no alopecia or external parasites notedAssessment:Fit for vaccinationIntermittent diarrhea: food allergy vs dietary intolerance vs infectious (parasites, viral, bacterial) vs otherPlan: Vaccinated with C5 SCDiscussed trial hydrolyzed diet for 6-8 weeks to see if diarrhea resolvesRecommended daily brushing of teeth as opposed to intermittent brushing for better effectiveness     Vital Signs    Weight: 8.8;