C09995145 / invoice 10000

Jo called to follow up what she does regarding booking Moose in with MVSC for Gastropexy at time of castration, AFB advised she has recommended Dr Arthur House who now works at MVSC. Relayed this information to Jo, she is happy to call them herself and get him booked in soon.

History:Presenting for a general health check and discussion regarding prophylactic gastropexy.Owner reports he is well in self. He can be very overwhelmed and anxious in new situations, particularly at the vet clinic. Overstimulated++He is not like this at home and is good on and off the lead, very responsive and quite calmThe owner notes he bites his toenails, possibly when they are long. He is also very sensitive about his feet being touched unless he is asleep.EDDU normally.Diet: Black Hawk puppy dry food with approximately an inch of SPD meat roll at dinner.Preventatives: NS Vaccinations: Due MarchCurrent medications: None.Exam:BAR, very energetic during the consultation. LOVES food treats but beware fingers!Mm pink, CRT <2sEyes  NADEars  Unable to fully assess due to sensitivity. What I did glimpse was N pink and clear but did not get to assess TMDental comments if any: Grade 0. Good teeth, owner gives Mighty Munch dental chews.Skin / Integument  NAD, perfectLymph nodes - NADCardiovascular auscultation quality - HR 120 bpm, tachycardic likely due to stress. No murmur auscultated. Auscultation was difficult due to his enthusiasmThoracic auscultation - NADThyroid - NADAbdominal palpation  Palpable umbilical hernia noted. It feels like a small, irreducible thickening containing what is likely small amt omental fat. The hernial ring feels rough on palpation. Owner reports the hernia was present on adoption and has not increased in size.Urogenital system  Desexed male.Musculoskeletal  NADNeuro - NAAnal glands: NABCS - 4/9. Weight 55.2kg.In house diagnostics:None required today.Assessment:1. Anxiety/Overwhelm in novel situations esp noted in the clinic environment.2. Umbilical Hernia: Small, non-reducible, containing suspected omental fat. No clinical concerns at present.3. Prophylactic Gastropexy Discussion: Owner is interested in laparoscopic gastropexy to prevent gastric dilatation-volvulus (GDV), given the 50% risk in the breed.Treatment:Dispensed Gabapentin 600mg 1 tab/day (max 2.5 tabs) and Trazadone 200mg 1.5 tabs/day (max. 2 .25 tabs) pre any anticipated events to keep him calm and no in overwhelmDispensed 5.5 tapewormer tablets.Plan:Discussed situational anxiety medication (e.g., Gabapentin) to be used as needed for stressful events like vet visits or bathing.Discussed options for prophylactic gastropexy, with a preference for a laparoscopic approach due to being less invasive. Recommended repairing the umbilical hernia at the same time. ST House at MVSC, 3 to 3.5K and he will let me know availability for laporoscopic gastropexy

Jo would like to proceed with the Endoscopic Gastropexy and (possible- O thinks it has reduced substantially) hernia repair for Moose. Explained that the estimate from MARS will most likely need to be updated, and the hernia should be checked before being ruled out completely. Spoke to AFB and advised the recovery would only be a few days. Also that going ahead as soon as possible would be advised.Also suggested that we see Moose for a GHCU to assess the hernia before getting MARS to update the estimate.Waiting for Jo to confirm/book consult to check hernia.