C09994921 / invoice 10000

Reason: Re-CheckAppointment Notes: No improvement in appetite after Maropitant Injection.May need blood testing.SD    Vital Signs    

Reason: Cartrophen Injection 4/4Appointment Notes: LWArthritis consultPre-consult nurse initials:Michelle present Didnt want to eat much the past week, had a bit of vomiting and soft stool with CBD oil so owner stopped a week ago. Few days after 3rd athritic injection o has noticed Murphy is walking better. PE: BCS:   5/9HR: 100RR: pant Temp: 38.2cDemeanor: BAR Ears:NAD- No discharge or inflammation bilaterally.Eyes:NADNose: NADOral examination: MM pink, CRT <2 sec, moist.CVS/Resp: Clear BV sounds bilat. Normal Resp effort. No murmur or arrhythmia. SSFP.LNs: submanidubular LNs normal other LNs not palpated todayAbdominal palpation: Comfortable and pliable on palp, no pain.Integument:Clean coat, no evidence of ectoparasites.MSK: Ambulating normally. Right hip discomfort on extension - repeatable twice. Both HLs good muscle tone. FLs no pain. Back and neck manipulation NAD Urogenital: NADNeuro exam: normal mentation, full neuro exam not performedRectal: not performed Lab: nil todayAssessment: arthritis, no other abnormalities detected on PETreatment: Methadone 0.52ml SCCartrophen 0.52ml SC Metacam 0.69ml SC Metacam oral start tomorrow afternoon for another 4 daysClient communication: If still inappetance in 24hrs will need recheck and full bloods If right hip still painful will need xray    Vital Signs    Weight: 17.2;       

Reason: Cartrophen Injection 3/4Appointment Notes: ARArthritis consultPre-consult nurse initials:Murphy came in today for his Arthritis Injection.This will be his 3rd injection and the 4th injection will be with the Vet.Vaccination status: UTDFlea & Tick prevention:Worming:Heartworm:Other medication:Diet:Behavioural issues/observations:Microchipped:TruLove: DECLINEDVIP: NOInsurance: YESEDO (Trupanion):Examination:Arthritis: Mild/Moderate/Severe Effecting the:  __  joint/s.Discussed graded exercise regime involving...Recommended 4CYTE, Beranza, pentosan polysulphate injections, Metacam oral.Discussed weight loss strategies involving:Discussed warm soft bedding.    Vital Signs