C09994579 / invoice 10000

Appointment Notes: Digger (Dog) - Consultation (illness, check-up etc) [Veterinarian : Dr. Julian Sze(No Preference)] - Lame front paw (right)?????Subjective:History: Digger, a 7-year-old Miniature Schnauzer, presented for a sore right front paw. The owner first noticed an issue on Sunday (5 days ago) after a walk, with lameness developing over the last 2-3 days. Licking of the paw commenced on Monday or Tuesday. Digger had an emergency cystostomy over the summer for approximately 70 bladder stones that were causing a near-complete urinary obstruction. He has recovered well from surgery and is now on a prescribed urinary diet. The results from the bladder stone analysis are still pending. The owner has given permission to obtain his full history from his previous veterinary clinic.- Clinical signs/progression: Right front paw soreness began Sunday. Licking started Monday/Tuesday. Limping started Wednesday/Thursday.- Significant history: Emergency cystostomy two months prior for urolithiasis (70 stones).- Current medications: Prescribed urinary diet.- Appetite & diet: Consuming a urinary diet, to the exclusion of other foods.- Allergies: No known allergies to medications.Objective:Vital Signs:- Heart Rate: Within normal limits.- Respiratory Rate: Within normal limits.- Temperature: 38.2°C.Demeanour: BARExamination Findings:- Eyes: NAD.- Ears: Hairy pinnae (breed appropriate), canals clean. NAD.- Oral: Mucous membranes pink and moist. CRT 1 second. WNL.- Nose: NAD.- Peripheral lymph nodes: WNL.- Cardiovascular: WNL.- Respiratory, breathing: WNL.- Urinary/Genital: WNL.- Skin: Coat in good condition with some minor matting and burrs. Right forepaw is erythematous, moist, and swollen between the digits. No foreign body or laceration identified. Left forelimb dew claws are long.- Abdomen: WNL.- Rectal examination: not examined- Neurological: NAD.- Musculoskeletal: Lameness noted on the right forelimb.- BCS: 5/9.- Hydration: WNL.- Other Findings: N/A.Problem List:- Right forelimb lameness.- Bacterial pododermatitis of the right forepaw.- History of urolithiasis.- Overlong dew claws on the left forelimb.Assessment:Digger presents with an acute onset right forelimb lameness. Clinical examination and in-house cytology (tape preparation) confirm a bacterial pododermatitis. The infection is likely secondary to irritation or a minor skin breach, exacerbated by licking. The patient has a significant history of calcium oxalate urolithiasis, managed with surgery and a therapeutic diet.Plan:Treatment Plan:- Carprofen injection administered in-clinic for 24-hour pain relief.- Dispensed oral antibiotics (unspecified): Half a tablet twice daily with food for one week.- Dispensed Carprofen tablets: One tablet daily with food for five days, starting tomorrow.- Dispensed Chlorhexidine solution: Apply to the affected paw once daily for five days. Leave on for 10 minutes before rinsing.- Hair on the affected paw was clipped to facilitate topical treatment.- Recommended use of an Elizabethan collar to prevent licking.- Recommended trimming of long dew claws.Progress Notes:Client Communications:- Discussed the diagnosis of bacterial pododermatitis based on cytology.- Explained the treatment plan, including the importance of completing the antibiotic course and using an E-collar.- Advised the owner to follow up with the previous veterinarian regarding the stone analysis results and to schedule a urine re-test, which is recommended 2-3 months post-cystostomy.Additional:- Prognosis for resolution of the pododermatitis is good with compliance to treatment. Client declined dew claw trim at this time.?????    Vital Signs    Weight: 14;