C09991533 / invoice 10000

Pu/PdHas lost weight by reducing food. O noticed drinking more, urinating more and having pee  in house, fecal continent but semi soft pooAppetite good. Energy goodDue vacc end this monthStill chews feet and Every few months still having episodes of disorientation and legs give way lasting a few mins. Episodes used to be every 5-6m. No known triggers. O to keep diaryExamine: - BAR- MM pink CRT 1.5s- HR 140- Clear lung sounds- No murmur or arrhythmia detected- Abdomen: soft and comfortable- Skin, eyes, ears ok. Not scratching now just licking and o feels cytopoint last year did not help feet licking- Oral cavity: DS 1/4- LNs WNLSyncope? Vs neurological, no audible heart murmur, O to video the event if possible advised again. Advise investigate pu/pd and seizure type episodes with bloods-sent bloods to gribbles and Ml to call with results next Wednesday    Vital Signs    Weight: 8.3;       

Reason: VaccinationAppointment Notes: Special payment terms existHistory: - Here for vaccination, worming every 3 months up to date.- EDDU all well at home, itching badly, also had 2 episodes when he fell on the ground, legs crossed. But took few seconds to get up and running like a puppy..Examine: - BAR- MM pink CRT 1.5s- HR 140- Clear lung sounds- No murmur or arrhythmia detected- Abdomen: soft and comfortable- Skin, eyes, ear: mild erythema- Oral cavity: DS 1/4- LNs WNLAssessment: Clinically healthy for vaccinationSyncope? Vs neurological, no audible heart murmur, O to video the eventPlan: C5 injectable vaccinationProheart 0.5mL SCCytopoint 20mg SC    Vital Signs    Weight: 10.4;       

Reason: Vaccination + Heart Worm Inj Appointment Notes: Special payment terms exist, Overdue remindersPE NAD    Vital Signs    Weight: 10.1;