C09993093 / invoice 10000

Reason: Ghc Will Have GabaAppointment Notes: ------- Sms reply: YHistory: doing well at home. No v/d/c reported. Eddu normal. Been for few weeks- months noticed trouble with getting up from laid/ sitting position. No issue with jumping into the car and running in the yard. Very active otherwise at home. Mostly outdoor- on concrete in the yard.Also think she is very anxious, barks constantly at home esp when neighbours talking outside their house, will bark aggressively and run up and down the fenceline. Examination: - Checked at the back tx room- Zeyn held- calm and ok to examine. -PR normal. BAR in consult. -Dental- can see good teeth- reported to eat bones regularly- avid digger. -Chest clear and heart ausc ok, no murmur ausc. No pulse deficit. -Abdo palp- soft and comfortable. No mass effect.- BCS- overweight- advised to reduce food intake. -Eyes nad-Ears- clean, no smell- Ambulatory- forelimbs nad. - left hindlimb normal ROM. - right hindlimb- slightly reduced CP- neuro? But no signs of ataxia. Crouching low with hindlimbs. - Right hip and stifle- slightly tense/ tight when ext. - no swelling or muscle atrophy. - back palpation normal. Normal dorsal hip joint palp. Assessment: OA vs neoplasia vs neuro? Treatment: advised will trial nsaids for pain relief. If response, recommend xrays under GA- discussed options of anti-anxiety meds- 1- fluoxetine- long term mgmt- cannot stop abruptly2- gabapentin3- trazodone- long / short term- can adjust dose and may be used stop/ start, may use in conjunction with fluoxetine if needed (can trial some with trazocalm- if working well, can do BOVA order) Plan:    Vital Signs    MMColour: pink;       Weight: 40.0;       HeartRate: 80;       BodyScore: 7/9;       DentalGrade: 0-1/4;       CRT: <2s;       

Reason: Ghc (Poss Intermittent V+)Appointment Notes: ------- Sms reply: YReason: History: DUDE all normalNo dischargesNo V/D/C/SNo lameness, but becoming stubborn on walks and refusing to go normal distance, also stiff in morningsNo current medicationsExamination: Very distressed - clients had to fight her to get her on sclesPacing and moving away, pantingReally difficult to assessSalivatingAbandoned examLaboratory: Assessment: Likely OA and age related changesmoderately high BCSTreatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Weight lossPlan:Gabapentin for next exam    Vital Signs    Weight: 39;       BodyScore: 6;       DentalGrade: 0;