C09996110 / invoice 10000

REASON: Weight management and altered vocalisation.HISTORY:- Presented by the owner for an altered meow and for weight management advice.- meow is 'strained' and a bit more hoarse. Happens for 30-60mins, and has had a handful of episodes in the past 6m. P is otherwise normal during these episodes- The cat is reported to be otherwise well, with eating, drinking, urinating and defecating normally.- He is an indoor-only cat.- Weight has fluctuated over the last year, from 6.85 kg down to 6.5 kg, and is now 6.7 kg.- No heavily scented products used in the house- Diet: Royal Canin. The owner is using two automatic feeders.- Current medications: nilEXAMINATION:Bright, Alert, Responsive.BCS: 4/5 6.7kgDental/Oral: MM pink, moist, CRT<2s, dental grade 0/4. Throat palpated normally.Ocular: bilaterally symmetrical, no abnormalities notedOtic: ears clean and healthyCardiovascular: Heart sounds normal, rate and rhythm appropriate, pulses strong and synchronous.Lymph Nodes: all peripheral LNs WNLsRespiratory: Lung sounds normal, no adventitious sounds, normal respiratory rate and effortGastrointestinal:- Abdominal: relaxed and comfortable, normal gut sounds- Rectal: not performedUrogenital: normal, no abnormalities notedIntegument: Skin normal, no erythema. Coat normal, no alopecia. Normal skin tentsMusculoskeletal: normal, no pain on palpation or manipulation of limbs or on spinal palpation. Normal ROMNeurological: no obvious neurological deficitsTemperature: temperature not taken to facilitate positive experienceDIAGNOSTICS: Nil performed.Problem List:1. Altered Vocalisation- Assessment: Laryngeal/pharyngeal function appears normal on physical examination. No obvious cause identified.- Plan: The owner was advised to take a video of the abnormal meow and a video of the normal meow for comparison at the next visit.2. Overweight- Assessment: The patient is overweight with a history of fluctuating weight despite attempts at dietary management. He has a large frame but is carrying excess weight.- Plan: A diet change to a prescription weight loss food (Royal Canin Satiety or Hills Metabolic) was recommended. This is more targeted for weight loss and may improve satiety compared to simply reducing the quantity of his current food.ASSESSMENT:The patient is clinically well on examination. The primary concerns are the altered meow and difficulty with weight loss. For the vocal change, further investigation via video comparison has been recommended as a first step. For the weight, a specific prescription diet has been recommended to aid in achieving a healthier body condition.TREATMENT:- Nil in clinic.PLAN:- The owner will transition the diet to Royal Canin Satiety.- The owner will monitor for any changes and attempt to record a video of the altered meow.- Recheck consultation recommended as needed.    Vital Signs    MMColour: pink moist;       Weight: 6.7;       HeartRate: 172;       BodyScore: 4/5;       DentalGrade: 0/4;       RespirationRate: WNLs;       CRT: <2s;