C09993789 / invoice 10000

Subjective:- Recheck for a ruptured anal gland abscess approximately two weeks post-surgery.- Post-operative course included antibiotics and anti-inflammatories.- Owner reports Ulla is back to her normal self.- Owner also requesting advice on timing for due vaccinations.- No history of diarrhoea or softer stools prior to the abscess. The abscess developed and ruptured over a 24-hour period.Current Medical Conditions & Medications:Ruptured left anal gland abscess (post-op)- Amoxiclav, ongoing.- Anti-inflammatory, completed course 5/7 post-op.Diet:Dog food only.Previous Diets:Not discussed.Other History:- Social history: Apartment dog.Past medical conditions:- Ruptured left anal gland abscess approximately 2/52 ago, treated with surgical cleaning, flushing, antibiotics, and anti-inflammatories. This was the first occurrence.- History of high lymphocytes on a previous assessment.Preventative Medicine:Last Dental-Not discussed.Flea & Tick -Not discussed.Tapeworm/ Intestinal Worming -Not discussed.Heartworm -Not discussed.Vaccination -Due, delayed due to recent health issues.OBJECTIVEDemeanour: Bright, alert, responsiveEyes: Bilaterally symmetrical, no discharge or blepharospasm notedEars: Clean and normal appearance externallyMucous Membranes: pink and moist with CRT<2secCardiorespiratory system:HR - WNLNormal cardiac rhythm and character, femoral pulse normokinetic and synchronous.Respiratory system:RR - WNLNormal bronchovesicular sounds auscultated over four quadrants of the thorax, normal respiratory character.Peripheral lymph nodes: No obvious enlargement palpatedGastrointestinal: Abdomen soft and comfortable with palpation. Left anal gland not full. Right anal gland contains some content.Musculoskeletal: Comfortable with appendicular joint manipulation and DV palpation of the spine.Skin and coat: Surgical site for anal gland abscess is ~90% healed, with minor flaking and crusting.Urogenital and Reproductive: vulva without discharge or other abnormalities, mammary chain wnlAssessment:- Ruptured L anal gland abscess (healing): Post-operative recheck. Left gland is empty, indicating good drainage. Right gland has some material. Predisposing factors discussed include stool consistency and episodes of gastrointestinal upset.- Vaccinations due: C5 vaccination pending. Cannot be given while on antibiotics due to the bacterial component of the vaccine.TreatmentNil given in consult.Plan:1. Schedule a vet appointment in 2w for anal gland expression and C5 vaccination. - Agreed to proceed with this plan.- Counselled owner on monitoring stool firmness and the option of adding fibre (e.g., psyllium husk) if stools become soft.- Discussed the plan for managing anal glands involves regular expression at increasing intervals to prevent recurrence. Current plan is 2 weeks, if clear then, can space out to 4 weeks Follow-up actions:Book nurse appointment for anal gland expression and C5 vaccination in 2/52. Brief nurses on the plan to space out expressions based on findings.    Vital Signs