C09993048 / invoice 10000

Appointment Notes: Paws App Details:Booking Type: Vaccination & Health CheckBooking Notes: Off her food and possible upset stomachPet Insurance Provider & Policy No (if applicable & not provided): HC19004441History:Constant D+ for past few days - watery, no blood Did bring faecal sample Off food - still acting a little but does take bribing More lethargic than normal Had a little vomit 2 days ago straight after food, but none since Had giardia as a puppy Diet: kibble AM black hawk, evening wet food (supermarket brand) - can be fussy Had a small amt plain chicken breast lunch time Worming UTD Veyr slow eater, struggles with hard object Objective: Sub: BAR, HR = , no murmur/arrhythmiaRR  bpm, no adventitious lung soundsMMs pink/moist, crt 1sTemp: 38.6 Eyes: nad shiny clearEars: clean Teeth: clean Coat:shiny, wnl Skin: nad Abdo: comfortable LNs: nad BCS: 6/9MSK: ambulating well Neuro: ne UroG: nad Sore in tummy Dried faeces around bum Assessment: Treatment: Pro-kolin 5mls BID Fenbendazole 12.5mls SID for 3days Ondansetron 8mg Panadol 500mg BID 5 days Client Communication: Plan:Revisit if not resolving    Vital Signs    Weight: 25.6;       

Reason: LimpingAppointment Notes: Paws App Details:Booking Type: ConsultationBooking Notes: Limping. Suspect something in her paw. Lots of licking.History:On thursday - removed a prickle from front R foot Has still been licking since then quite obsessively Os have looked at home, and could not find any obvious wounds ect Limping slightly, worse at home Not been walking herOtherwise well, EDUF all ok Objective: Sub: BAR, nice but foot shy. Eventually growling HR = 90bpm, no murmur/arrhythmiaRR = panting, no adventitious lung soundsMMs pink/moist, crt 1sTemp: ne EENO: wnl, shiny and clear. Not fully examined Coat: moist fur from licking RF Skin: Interdigital skin and lateral aspect of RF moderately inflamed, erythemic and moist. No obvious FB however eventually lost patience when trying to shave the foot, grwoling ect. Abdo: comfortable LNs: nad BCS: 5/9MSK: weight bearing lameness RF Neuro: ne UroG: nad Assessment: RF lameness - ddx self trauma post prickle removal vs FB/grass seed vs insect bite vs other Treatment: Meloxicam 25kg dose for 5 days - has at home Neocort cream BID onto paw Amoxyclav 375mg BID PO 7 days Clean paw with dilute betadine O to try clip paw at home (grooms her themselves as she doesnt tolerate groomer) and to examine paw Client Communication: Discussed cannot rule out grass seed today due to limited exam. Would require a full sedation/GA to properly clip and explore foot due to temperatment. Os understand Plan:Monitor response to tx - if no improvement over the weekend then book for sedation/GA explore Gabapenin prior to next visit - O thinks has some at home    Vital Signs    Weight: 26.9;       

Reason: V. Lethargic, Not HerselfAppointment Notes: SMHx:Last few days - not herself, lethargic.Not as interested in food - eating less.No v/dLess poos, no straining. Small ones.No soreness.Does chew twigs sometimes. O thinks FB unlikely though.Phy:Nervous but ok for exam.Oral- mm pink moist, CRT < 1 second H/l ok HR 116Mild pyrexia, though tense/nervous.Abdomen - slight tense, but some struggling/nervous. No swelling. No obvious constipation.Palpation of lumbar spine - some reactivity - true soreness?Discussed BT  vs  trialing conservative  tx for mild soreness of lumbar area + cover for mild constipationTx:Trial meds - mild soreness lumbar areaStrict rest.Will give  paracetamol 1/2 to 1 tablet BID 1-3 daysIf no better/worsens recheck and BT +/- abdom imaging    Vital Signs    Weight: 25;       Temperature: 39.6;