C09992757 / invoice 10000

LethargicNurse:Any concerns the owner has / presenting problem and duration: History:- last few weeks just seems really tired and lethargic- also seems at times a bit uncoordinated and slow/wonky in hind end esp at night when more tired- O's feel a bit uncomfortable in general lower back/hind end when having her usual massage at home. Male O queries favouring RHL at times- still enjoying walks- no seizures- eating/drinking/toileting normally- needs another script for doxy for onychodystrophyDiet:Parasite control: Microchip scanning:Vacc history: Current medications:  Vomiting / diarrhoea:   noneDefecation: Urination: Eating/drinking: Any concerns the owner has: Exam:Mentation BAREyes - clear, cornea all appears WNL, no tear stainingEars - clearNose - clear, no dischargeOral - DS 1, mm p<2sThyroid palpation - all palpates normalLymph nodes - all WNLCardiac:-   NADRespiratory:-   NADAbdo - soft and pliableGenitourinary clearMSK - bi uncomfortable palpating lower back, no obvious pain displayed on ROM hind legs. No pain moving neck.Neuro - clearIntegument - no concerns today  *nails much imrpoved on onychodystrophy meds/supplementsTemp:-  38.4BCS 4/5Assessment: Last few weeks looks tired/lethargicPlan:bloods to lab to assess any systemic causes of recent lethargyrenewed script for doxycycline    Vital Signs    Weight: 9.1;       Temperature: 38.4;