C09996775 / invoice 10000

Reason: Vacc & BeransaAppointment Notes: CTHistory:Doing well Has bad reaction with Meloxicam, only giving every 4 days Wanting to start on Beransa again today Still definitely having a bit of spinal pain and hip pain Only seeing head tilt when he is tired Examination:Mentation: BAR, BCS 7/9Peripheral LN: WNLEENO: NAD Teeth: 0/4 Cardiovascular: no murmurs or arrhythmiasPR = HR 120Respiratory: no adventitious lung soundsGastrointestinal: soft and comfortable abdo palpationMusculoskeletal:  normal gait, full msk exam not performedIntegument: no lumps or bumps, skin and coat in good conditionUrogenital: WNLAssessment: Fit to vac Generalised osteoarthritisTreatment:Vaccination: Dc4 subcut, oral BB Beransa 15mg subcut on LHL Plan:C5 vac given Beransa injection given, booster in 4-6 weeks timeStop meloxicam for the moment, able to give paraceotmol 500mg PO BID    Vital Signs    Weight: 27.1;       

Reason: Bladder Infection Again?Appointment Notes: has pre dropped off wee on Thursday - BAHistory: - Given us a urine sample yesterday, nothing overtly concerning - Was concerned of repeating UTI episodes again; will lick at penis - Also wanting to keep him as comfortable as we can, but not with Meloxicam - had a bad reaction - Wanting to check his eyes - With his vestibular syndrome, wax and wane; sometimes will see head tilt, but will not fall imbalance Examine: Mentation: BAR, able to jump from me promptly in consult Peripheral LN: WNLEENO: bilateral nucleosclerosis: normal lens changes with ageTeeth: did not check Cardiovascular: did not check Respiratory: did not check Gastrointestinal: soft and comfortable abdo palpation, bladder empty Musculoskeletal: bit uncomfortable on caudal spine region when palpating Integument: no lumps or bumps, skin and coat in good conditionUrogenital: rectal exam showed normal faeces, normal anal glands, not painful on prostate palpation; prepuce is clean, able to extrude with no issues, no swelling or discharge seen on penis Assessment: - Vestibular syndrome - 90% healed, sometimes with head tilt - Osteoarthritis on the spine and hips - UTI - don't think he has it at this moment Treatment: - Carprofen 25mg po bid - Ondansetron 8mg tabs x 8 Plan:- Commence Carprofen (advice to start on Mon 22/9 in case if side effects and we can see him urgently during weekday time)- Commence Ondansetron as needed for his chronic vestibular syndome- No further action on his prepuce    Vital Signs    Weight: 27.3;       

O dropped off urine sample for testing today, has appt fridayLaboratory: Free catch urine  Results:Turbidity: Clear Colour: very light yellow almost colourless USG: 1.012Dipstick:pH: 5.0Leu: neg Protein: 1+ Glucose: negativeKetones:negBilirubin: neg Erythrocytes:1+ Hb:Sediment: unremarkable, barely any sediment. No crystals or cells, just some debrisRemainder of urine kept in sample pot in consult 2 fridge    Vital Signs