C09991508 / invoice 10000

Hx: Urine is no longer smelly. Still weeing in her crate (is moreso a playpen) at night. O has added puppy pads to crate. OR dog was crate trained prior to her getting dog (in Dec 25). O unsure if she was closed into a crate though - perhaps more of a pen. No issues at all with urination initially - for the first couple of months. Only recently developed. Isn't urinating in little bed she sleeps in, does get out of bed to actively urinate. O does not think dog is drinking too much water. Doesn't notice her drinking much at all. Possible that Jasmine is starting to settle into her new environment, decompress etc, as she is beginning to show new behaviours. ie: appeasement behaviours, licking people a lot, stopping suddenly on walks & refusing to go any further (previously walked fine with owner). O unsure if cytopoint helped, still licking people a lot but not herself. 

Exam:
Exam as per previous (20/02)

Urinalysis: 
USG 1.038 
pH 5
All other parameters neg/norm
Cytology unremarkable 

Tx:
Nil

Plan: 
Recommend return for external bloods when ready to check general health. May need to consider medication trial if stress levels & behaviours continue.  
If urinary issues continue, consider abdo u/s with cysto as well. Does not sound like USMI case. O on board with plan. 
Discussed cytopoint wont stop her licking others, but should help with any itchiness or irritation on herself (paws, back end etc). 

Hx:
She is urinating where she shouldn't be
Sleeps in a crate and urinated in front of her bed and urinated on the kitchen floor. O unsure if intentional squatting and urinating or if it is just coming out. May have urinated in bed and it came out under to the front of the crate.
She has been desexed in November last year
She licks constantly, paws, backside etc

Exam:
BAR, friendly 
BCS 5/9 
HR/RR WNL, cardiac ausc NAD, lung fields WNL, MMp/m, CRT <2
EENO grade 1-2 dental tartar, otherwise NAD 
MSK NAD 
Integ generally pink skin but looks normal for dog 
Abdo palp NAD 

Tx
Cytopoint given 
10mg Batch #828805 Exp: 01/2027

In House Urinalysis Results:
USG: 1.050
Slides Prepared? (Y/N): Y
LEU: 2+
pH: 7
PRO: 1+
GLU: Normal
KET: 1+
UBG: Normal
BIL: Negative
ERY/HB: 1+

Cytology: rods ++, cocci +++, WBC +++, RBC ++ 

Tx:
Cytopoint 10mg SC inj 
Amoxyclav 50mg 1.5 tablets BID 14 days

Plan:
Trial cytopoint for potential pruritis/licking. O to report back if it improves things. Discussed can have nurse injections for 6mo after vet appt. 
Tx UTI. Reassess urine after abx finished. May need abdo u/s + cysto if repeated issue. 

Hx:
BIOP for 11 days. 
OR was 5.9kg at pick up.
Presented today for vaccination, posb nail trim. Licking RF paw. 
EDUD WNL 
Diet: dry and wet food. Advance small/medium breed dry. Prime 100 chicken and vegetable roll. Using for training as well. 
V- D- 
Previously been to High Street Vets Strathalbyn
Follows mum around a lot. 
Parasite prevention: Nexgard Spectra with previous owner. Tapeworm also done separately. 
NIL Medications. 
Recently speyed. Had a previous litter but resulted in emergency c section and loss of puppies. Was decided not to be bred again.

Exam:
BAR - happy girl but a little nervous
BCS: 4/9
M/S: NAD
Dentition: Recently cleaned, mild tartar build up on canines 
C/V: NAD
Abdo: NAD 
Skin, ears, eyes: Tear staining bilaterally. 
Paws - no obvious trauma/FB. 
MM/CRT: Pink, moist
Spey wound looking healthy. 
Exam otherwise unremarkable

Tx:
Vaccination c5 administered s/c 
C3 B: 2513403    Exp: 04/27
Bb/Pi B: 2505002   Exp: 10/26

Examined all paws. Possible self soothing with adjustment to new home. Discussed possibility for allergies if continues. 

Plan:
Discussed nexgard spectra or equivalent qmonthly, tapeworm 3monthly if wanting to do both still. Adv low risk of tapeworm if not feeding a raw diet or on farm.
Discussed tear staining can be wiped away gently with moist swab. Can use specialised products with tear staining (checking with MB what uses at home). If increased discharge, investigate further. 
Discussed dental prophy options at home. 
Vaccination due in 1 year.