C09995976 / invoice 10000

Dermatitis/pyodermaHistory: Scabs under chin recently. Chews feet.Overdue vaccinationsCurrent with Nexgard SpectraEntire bitchSleeps indoors on downstairs couchHas Trad at home.Examination: BCS: 3/5 Very BARDental grade 1/5MM pink and moistCrusting/scabs matted under chinEyes and ears normalLN normalHR 124 No murmurRR 44Abdo palpation unremarkableAssessment: Pyoderma/dermatitisTreatment: Cleaned and removed scabs. Washed with Malaseb.Plan:Cephalexin 200mg bid for 10 daysPred 5mg sid for 5 daysRe-examine in 10 days or sooner if deterioratesPossible vaccination in 10 days    Vital Signs    Weight: 9.39;       

Health examinationHistory: Book in for desexing today. Due for vaccination in October.Going well at home. Chews everything, sometimes may ingest parts of objects. Ate a bluebottle earlier this yearWas on heat January 2025.Overdue Nexgard Spectra by 4 days.EDUD all normal. Mobility is good. Diet: Petbarn wet food. Examination: BCS: 3/5. BAR - friendlyNo deciduous canines. HR 124 no m or aRR sniffing / panting / licking.No herniasAssessment: Healthy and ok for speying in late AugustTreatment: None indicatedPlan:Estimate for spey provided; with and without HPP inclusionsDispensed Nexgard Spectra    Vital Signs    Weight: 7.92;       

Reason: D++ With Blood - JOAppointment Notes: Overdue remindersHistory: started to have D+ with fresh red blood- started after got home from groomer. Hx has had GI upset in the past which resolved with bland diet and pro-kolin. EDU normally. No lethargy. Is known to eat non food items + does try to eat other animal faeces. No bones. Feeding: puppy food some kind of fresh but frozen. No pork or lamb or anything fatty. Gets liver treats. Groomer hasn't mentioned she is anxious for grooming. Seemed to strain a bit when trying to defecate. Formed to D+ consistency. No V+- known to have occasional V+ but none for a while. No current meds. Prevention: nexgard spectra UTD due in 8 days. O has no other concerns. Examination: VERY BAR- friendly excited HR: 132 no M or A RR: PANT BV sounds clear LN WNL Ears eyes nose all clear Oral exam: retained 504 and 604 otherwise NAD INTG: NAD MSK: NAD Abdo palp: NAD comfortable CRT; <2 MM P:M Rectal exam: small amount of blood on glove otherwise NAD Normothermic 38.7Laboratory: NA Assessment: Acute GI upset/HGE likely associated with stress from groomer visit but cant be sure without further investigation- as is still BAR and EDU normally will attempt conservative management first but if no improvement by day 3 or if gets worse will need to reassess with rads or PCR pending how presents. O will chat with groomer about if bonnie is anxious at her visits or not. Treatment: NA in consult Consent has been given by the client to proceed with this treatment  -  YesPlan:Pro-kolin 3ml BID until finished Bland diet recommended hills I/D but O would like to do boiled chicken and rice for 3-5 daysRC if no improvement by day 3, not resolved by day 5 or sooner if gets worse    Vital Signs