C09997985 / invoice 10000

HISTORY: Presenting issues:
d+ started four days ago, bloody stools with mucous
Had prokolin since Saturday but no improvement
The other dog also hadd D+ but resolved couple days ago with prokolin and metrobactin
Flatulence
Coughing like he is choking
hasn't had good appetite today
Went to the groomer last week
Is a scavenger

Worming UTD: Y paragard
Flea and tick UTD: Y bravecto
Current medication N

Examination: 
Demeanour- BAR
BCS (1-9) -     4/9                
Eyes- no abnormality detected (NAD)
Ears-  NAD
Teeth/mouth-       Teeth Grade (1-4)  1/4 mild plaque     Dental Required Y s&p            MM: pink        CRT: <2seconds
Chest    Lungs-      bpm NAD         Heart rate-  100    bpm                   Heart murmur- N
Abdomen- NAD
Peripheral Lymph Nodes: NAD
Skin- NAD                    
Neurological - WNL
Rectal Exam - dark mucousy stools
Musculoskeletal -   NAD                 gait: NAD       

Differenital diagnosis and client discussion: 
> Ddx: large bowel disease

Plan:
> Metrobactin 250mg 1/4 tab PO BID x 6d
> Can dispense Linctol 2ml PO BID x 5d if O inquires in the next 7 days
WEIGHT: 5.80

NOTES: Has been chewing his penis since a pup, also has been chewing his feet recently

PE: 
non erythema over all feet

Discussion:
> Suspecting behavior issue
> Discussed Zylkene and anti-anxiety meds
O elected to try zylkene

Treatment:
> Lepto 2 SC given

HISTORY: Prev Vet: Kogarah Veterinary Hospital 

History: Here for C7 vaccination and  HW inj and anal glands and nail trim. EDDU normal. No CSV+D+. 
UTD on bravecto 

Examination: 
PE unremarkable 
- anal gland expression NAD 
- nails clipped  



Assessment: Suitable for Vaccination

Vaccination given Nobivac DHP SC , Nobivac KC, Lepto 2 (need lepto 2 booster in 2 weeks no charge)
 SR12 0.3ml inj SC 
Next Vaccination                  due: 1 year from now        DHP + KC + Lepto 2 

Have all reminders been updated for this patient? Y
WEIGHT: 6.00