C09992583 / invoice 10000

Reason: Limping For 2 Days Getting Worse Although Does NotAppointment Notes: to be in pain  jcHistory: Notice holding RF up at times for the past few days, still very BAR and running aroundExamination: BAR, boisterousBCS 5.5/9Pink mmDental C0G0Appears fully sounds on all fours RF exam: possible swelling on dorsal metacarpi, evident erythema in between pads, no palpable crepitus, no reaction on full leg ROM, no visible wound/FBLF nadLaboratory: Assessment: tendinitis vs insect bite? Treatment: metacam sid x 5 days, strict rest, chlorhexidine wash for the padsConsent has been given by the client to proceed with this treatment  -  Yes/No Plan: revisit INI for sedation +/- rads    Vital Signs    Weight: 36.6;       

Appointment Notes: Booked Online: 20/08/2025 08:38:40 AMHistory: Presenting for 3rd vaccsHas started some mild diarrhoea since Friday Was fed different food to normal on FridayAlso has been itching at ears over same time periodExamination: Attitude: BAR - very mouthy puppyHR: 120RR: 20MM: Pink, MoistCRT: <2sBCS: 5/9Eyes: No discharge, no redness, no blepharospasmEars: Mild inflammation of both pinnaOral: No dental diseaseCardio: Normal rate and rhythm, no obvious murmurs detectedResp: Normal rate and effort, normal bronchovesicular sounds notedAbdo: Soft and comfortable on palpationNeuro: No altered mentation, no CP deficits, cranial nerves normalMusculoskeletal: No obvious lameness or joint swellings notedSkin: No parasites or inflammation notedAssessment: Fine for vaccsDiarrhoea - change in foodItchy earsTreatment: Ear cleanerProkolin paste Plan: Given C4 vaccEar cleaner for itchy earsProkolin for diarrhoeaRecheck if not resolving--- 10/09/2025 12:49:47 PM HEK:Vaccinations - Resolved -    Vital Signs    Weight: 18.2;       

Reason: 2nd Vax RLHistory: BIOP 3 weeks. Doing well at home.2nd puppy vaccination.Some delay in testes descending.Ate a lot on tues - drank a lot. Been okay since.Toileting well now. Gong outside more.Diet: puppy biscuit soaked and some raw food. Primal paws - roo jerky and raw foods. 3 times a day.No other animals.Simparica trio last sunday. Still got a normal wormer as well.Had ear mites initially - resolved with simparico trio.Examination: Weight: 11.2kgBCS: 4/9Demeanour on presentation: BAR, very socialTemp:	NP	HR: 100		RR: clear		Mm’s	PM	CRT 1-2s		Hydration: goodEyes: clearEars: clean clearOral: normal dental occlusion and dentition, no clefts or ulcersLN: WNLIntegument: soft shiny coat, no areas or alopecia or erythemaCV: strong regular heart, no mumur auscResp: clear lung sounds bilaterallyGastrointestinal: a bit full likely faeces and urine.Urogenital: ambulating wellMSK: good ROM ambulating well a bit clumsy on table.Neuro: menace and palpebral reflex intact.Assessment: Fit for vaccination.Treatment: C4 Protech Subcut left shoulderBb oral Protech bronchishield Consent has been given by the client to proceed with this treatment  -  YesPlan:Next C4 due in 4 weeks.Bb due in 1 year.--- 09/08/2025 09:42:22 AM SZE:Examinations - Resolved - Follow up text sent SZ--- 09/08/2025 09:42:32 AM SZE:Vaccinations - Resolved - Follow up text sent SZ    Vital Signs    Weight: 11.2;