C09995234 / invoice 10000

Clinical Notes 'Ok to send': [Initial and Date]History-BIB Judiechews paws- settles with zyrtec , bit anxious alsonoise phobicdiscussed licking/ chewing of paws and anxiety - self soothingDiet - stay loyal dry kibble 1/ in am + lamb puffs + sardines , 2/3 cup salmon of an eveningParasite control - advocate monthly + tapewormerCurrent meds- zyrtec 5mg SIDMicrochip - scanned and correct Last Database check ( if<2 year, review):Exam -Demeanour: BARTemp - 38.2BCS - 6/9Eyes NSFEars NSFOral exam: NSFDental grade: 1- discussedCardiac ausc NSF HR = wnl , clear heart soundsRespiratory NSF RR =wnl, clear BV soundsAbdo: NSF on abdo palpationMSK: NSF on joint palpationSkin: NSFL/Ns: NSF Other findings:Tests performed:Assessment:fit for vacc , inj s/c base of necko to monitor chewing at paws / anxietyin a new environmentPlan:Treatment:Nobivac Pi2Nobivac BB oralOther recommendations:watch weight - may need to reduce diet if not as active in apartmentNext point of follow up: annual check

Clinical Notes 'Ok to send': 10/12/24HistoryBIB JudieNoticed put on a lot of weight - seemed to happen when owners went away for 5 weeks mid year + speyed earlier in the yearToday didn't wat which she intermittently doesNo GIT upsetsNormal stoolsNormal urination and thirstDiet - 1 cup RC dry split AM/PM + treats inc fishParasite control - NGSNo concerns with skinCurrent meds nilMicrochip - scanned and correct Last Database check ( if<2 year, review):CAR, UTDExam -Demeanour: BARTemp - not takenBCS - 7/9, 3 kg gainEyes NSFEars NSFOral exam: MM pink, CRT < 2 secDental grade: 0/4Cardiac ausc NSF HR = 116, regular, clearRespiratory NSF RR = 20Abdo: NSF on abdo palpationMSK: NSF on joint palpationSkin: NSFL/Ns: NSFTests performed: NilAssessment:Healthy to vaccinateOverweightPlan:C5 vacTreatment:C3 Durammune  5262007, 06.03.2025                  Protech B3 (nasal) 5267019, 30.04.2025TWer POOther recommendations:Reduce dry food amount - if begging/scavenging, consider dietary foodIncreased exercise (difficult at the moment due to owner limitation)Next point of follow up: weight check + TWer 3 months

Primary Clinician YYLast Appt: 11/4Previous Plan (copy from hx notes):Recommend symptomatic management with chlorhex wipes after each walk and also once daily on lip foldsZyrtec 10mg SID trial. INI after a week then contact the clinic and YY can email antihistamine listIf worse, then recommend return for allergy workup.Recommend use bravecto next time advocate is due to switch things upBriefly discussed next steps to be food trial - did not discuss in detailOwner Communication: (incl name of owner spoken + time called):Zyrtec for 2 weeks, washing them, not tearing at her paws like before but still licking. O thinks is better but still not resovled.YY - anything else o can do as they sound like they ARE getting better.Ongoing Plan:Repeat Follow-up? Y [Date] / N Revisit? Y [Date] / N