C09996870 / invoice 20000

C5 and HWI
Also needs dental exam
Sophie also coming in for Beransa with nurse

EDDU normally, BAR. No V+/D+
No current medications 

Trazodone 50mg 2 hrs before grooming - still needs muzzle

Growling at other dogs and grandchildren occasionally

UTD Nexgard q 1mo  + drontal q 3mo

Examine
BAR
BCS 6/9
HR 120 no murmur or arrhythmias
MM pink and moist CRT <2sec
G 1/4 mild tartar on PM/M
Normal bronchovesicular sounds
T not taken
Abdo soft and comfortable on palp
MSK normal hip ROM, no stifle instability
Submandibular, prescap and popliteal LN WNL

Assessment
Mild periodontal dz - recc GA + clean and scale eventually, tooth brushing/dental treats

Behaviour - recc trialling fluoxetine (effect seen in 6-8 weeks), can use traz in mean time (short acting). Discussed can use traz 100mg 

Treatment 
Protech C3 + BB/Pi s/c
SR12 0.43ml s/c

Traz 5-10mg/kg 50-100mg 2 hrs before stressful event 




Traz pls

Traz 50-100mg 2 hrs before stressful events
Itchy skin

EDDU normally, BAR. No V+/D+  
Feeding Advance dog food

UTD Nexgard 

Itchy 4/10 for last few days
Apoquel 5.4mg given yesterday night - helped w itch

Traz 50mg effective before grooming/stressful events

Examine
Skin: mild erythema ventrum, ears minimal d/c so no cyto done

Assessment
AD - O happy to continue w Apoquel, declined trialling cytopoint. Can dispense 6mo worth if going well. Discussed AD may predipose to SBP/yeast overgrowth, but no current secondary infection needing oral Abx/a/f

Treatment
Apoquel 5.4mg 0.55mg po SID - can use PRN as needed

Dispensed more traz to use PRN

Plan
R/c 2 weeks or ASAP if not improving.