C09992986 / invoice 10000

Reason: LethargicHistory: Off colour Friday/ Saturday. Did not eat at all Saturday On Sunday seemed painful and reluctant to jump- up This morning 3am episode: difficult to rouse; unresponsive initially; later woke but sluggishToday improved significantly, ate some treats and a chicken breast, then schmackos.  Vomited after this. Bowel movement (O brought in sample) yellow brown semi formed. 45mins ago fed her another treat (beef stick), ate happily, ate 2 more schmackos, cooked chicken and rice. Ate this and has not vomited since.Very active; runs daily on 20-acre property; exposure to wetlands, creek, carrion and wildlife faecesIntermittent ocular discharge past 2 weeksDiet: Fed many scraps - bits of icecream, multiple schmackos and other high fat treats, left over food. Scavenges and gets possums, kangaroos, faecal material. Runs in wetlands. Parasuite prophylaxsis not UTD. On dietary supplement (Omega 3 fish oil for 3–4 weeks)Examine:BCS 7/9. Overweight. Nervous, pacing in consultMm pink, crt 1-2sec. Skin tent normal. EuhydratedT 38.6.Ears/eyes nad. Nil discharge Oral POD 1/4 HR 90 nad cardiothoracic ausc. Lung fields clear Abdo generally tense with handling, no specific area of discomfort. Small scab noted R LS spine; no tick seenMsk - fliches with palpation L1-L3. Sitting square, mild stilted gait in HL. Nop stifle effusion, good ROM hips/stifles/elbows. Even weight bearing. No neck pain. Can take treats laterally L&R, dorsal and ventral flexion nad. Assessment:GIT upset - pancreatitis, dietary indiscretion. Hx of hgih fat treats, overweight BCS and scavanging. Pale stools consistent with panc or GIt upset Possible msk pain (mid spinal) with inappetance and lethargy 2n dary to discomfort Ocular discharge likely allergic/environmental vs E canis or infectious Recommended  Options discussed: rest + pain relief; anti-nausea injection; blood tests (incl. pancreatitis); monitor and recheckClient declined diagnostics and in-clinic treatment; elected home monitoring due to improvementClient decline medications unless 'needed'. Adv that vomting indicates nausea and treatment is warranted - O decline. Plan: Home care: strict bland diet (chicken/fish and rice); stop fatty treats and supplement;rest from exercise for minimum 1 weekReturn if vomiting recurs, condition worsens, or no improvement in 24–48 hrs; recheck bloodwork (CPL + GHP) offered w/o cosnult fee if returning in 48hrs to encourage bloodwork. Ongoing, discuss weight loss and mroe consitent balanced diet with less treats--- 05/03/2026 12:40:59 PM HWE:General recheck - Resolved -    Vital Signs    Weight: 35.8;       

Reason: Licking PawsHistory:Since last visit has resonded with Cortavance but still licking it off feet. O concerned about small lesion medial knee. Enquring about Cytopoint injections - discussedBAR, still nervous - pacing around consult room - settles with treatsFeet seem worse after running around on wet grass. Examine:Mm pink. Gait normal. All feet moderately inflamed. Lower abdomen mildly inflamed.Removed grass seed form lesion medial knee. Assessment:Allergy/atopy - suspect contact allergyPlan:Given 40mg Cytopoint SQHome with Cortavance sprayDiscuss barrier treatments--- 12/02/2026 12:53:14 PM TSH:General recheck - Resolved -    Vital Signs    

Reason: Licking Paws, Check Ears And Possible Nail TrimHistory: Licking feet alot, especially in the mornings. Shakes her head alot in the mornings too, but she has always done that. Very loud. Would like nails trimmed. Due for vaccination. Does not need C3, but due for KC and proheart. O has decided not to give proheart inj anymore, would rather just given monthly tablets. Examination: BAR, BCS 3.5/5, dental score 1/4. Mm pink and CRT<2 secs. Dermatitis ventral RF and LF behind central pad. NAD webbing and other digits. Small graze on LH toe. Ears a little bit dirty, no inflammation, comfortable on palpation. Dew claws long, other nails short. Discussion: Discussed feet, there is inflammation behind the central pads, but the digits themselves are fine. It is possible that this is anxiety related overgrooming, she is a very sensitive dog. Or it could be an irritant. Discussed topical treatment, they have trouble getting creams on the skin, she does not like her feet being touched. Discussed cortavance spray. O does not have to touch her feet and it still works locally so there is not as much of an issue with exposure to steroids, If we are desparate then we can try oral steroids, but I would prefer to avoid this. O agrees, will try the cortavance. Do the first dose in consult. Treatment; Vacc KC. Dispensed cortavance spray (2 sprays to effected area once daily as required for itchy skin)Plan: Monitor skin, monthly worming and next vacc 1 year.    Vital Signs