C09993719 / invoice 10000

Reason: V+ & D+ CCLH 4/3 Appointment Notes: d+ yesterday, v+ today nohc eating & drinking ok, said may be running 5 minutes late advised if any later call as may need to rebook CCLH 4/3History: Went to Chartswood 2 weeks ago - though KC - but owner not convinced - not further deteriortation - ok after that - BAR ok, running around ok Keept home anyway Now - Sunday 3 days ago - poos a bit softer and slight increaase in frequecy Gave a probiotic - synbiotic  - 1 capsule - stools seems to settle last night  - no poo overnight Ate chicken this morning  - then when home at lunch time - severl v+ present in home Chicken normal diet  - always fresh cooked Was a little overexcited this morning - but doesn't normally v+ No change in diet  - very fussy, will only eat human food But willscavenge when walking Ate grass this morning Yesterday had something black on face - possible bird poo?? Drinking ok Weeing ok No faeces since last night Last V+ just over an hour Eyes - weeping started just over 1 yr ago - was fine prior Very anxious - when alone - seperation anxiety GIT dz - recurrin g- always sensitivite - trialled different foods - none seem to work or she refused to eat them Very idfficult to trial new foods with Examination: not agressive just anxious - good without owner MM:pink CRt < 2secsTeeth - grade 2 DD  - needs s&P Heart sounds norma lLungs ounds clear - panting heavily throughout Abdo - soft easily palapted, relaxied, no pain, no abnormalites detected LN - NAD Skin anc oat - NAD NAD onr est of exam Eyes - marked staining around eye - suspect blocked ducts - will check at time of detnal with fluroscein Laboratory: Assessment: Primary GI - unsettled from D+ - unknown cause, suspect grass tgis mornign trigger Treatment: Prevomax Plain diet R/c inin Plan: 1.  Trial synbiotic ongoing 3-6 months miniimum - see if stabilised GI dz long term - as food trial not really an option 2.  revisit for anxiety - owner going away - severe seperation anxiety - want to trial natural - zylkene plus vs serenic care 3.  Needs dental - - blocked nasolacrimal duct - trial flushing at time of dental - advised may have ,imited success    Vital Signs