C09995086 / invoice 10000

Appointment Notes: coughing after eating and wanting a overall health check - ashHistory: Intermittent coughing /loud upper airway noise, most noticeable after eating although episodes may also occur intermittently at other times. Video of episode sounds obstructive. The dog is also reported to exhibit episodes of reverse sneezing and occasional sneezing. Appetite has been good and general demeanour reportedly normal. O has also noticed possible reduced vision. Respiratory rate has been normal at home. Examination: Bright, alert, responsiveHR 120bpm, no audible murmur, regular rhythmRR 20bpm, no audible crackles or wheezes on thoracic auscultationBilateral mucopurulent discharge, nuclear sclerosis, PLRs intact, slight reduced menace response R eye, clinical significance uncertain, mild conjunctival erythema/chemosis No overt nasal dischargeOral exam: only few remaining teeth - periodontal disease and extractions required including lower canines, difficult to do thorough oral assessment at mouth shyBCS 4/9 Assessment:Conjunctivitis, reduced visionClinical signs may be attributable to several condition including:- nasopharyngeal obstruction or inflammatory disease- nasopharyngeal mass or nasal mass- chronic rhinitis/sinusitis- dental disease with secondary sinus involvementPlan: recommended advanced imaging (CT of the head and thorax). Tricin BID for 7 days then reassess. Recommend IOP (tonometry) and pre-GA bloodwork to check internal health at time of CT    Vital Signs