C09993510 / invoice 10000

Reason: TicksHx:Layla presented this evening as O concerned having lots of ticks in her paws causing excessive panting. No vcds, ate dinner well. Hiding under table during the storm which is unlike her, usually not phased. Went out for a walk this afternoon, off leash, O doesn't think have snakes about. Went to check her paws as has been licking at it and noticed lots of small tiny black dots. Had tried to remove them at home but hard to. Late with nexgard spectra. Physical exam:BAR, very nervous but friendly girlHR: 140, no heart murmur detected, normal rhythmRR: clear bronchovesicular sounds, no crackles/wheezesRE: 0/3Eyes/nose/ears: NADOral: pink and moist MM, CRT: 1-2sLNs: superficial LNs WNLAbdo: soft and comfortable on palpation, full msk exam not performedIntegument: shaved FL paws, 2-3 small black dots - on dorsal surface of paws - unable to remove with tweezers. Cannot differentiate if tick nymphs vs other.MSK: No ataxia, ambulating well on all 4xAssessment:Layla presented tonight as O was concerned about ticks on her paws and restlessness behaviour at home. No other clinical signs currently present.Possibilities may include anxiety and discomfort, irritation due to potential ticks on paws, insect bites. Plan:Given vague clinical signs, O to monitor for the little black dots at home - if they engorge and able to remove once bigger. Frontline sprayed in consultTo give nexgard spectra now when O gets home.    Vital Signs    Weight: 4.4;       MMColour: pink;       Temperature: 39.0;       HeartRate: 140;       BodyScore: 5/9;       RespirationRate: 44;       CRT: 1-2;