C09999588 / invoice 10000

Appointment Reason: Vaccination / Check Up / Spayed, Appointment Notes: Paws App Details:Booking Type: Consultation (Skin, Eye, Ear or Multiple Concerns)Booking Vet: - Any -Booking Notes: Vaccination & general check up. Also maybe booking in her to be spayed. I also want to check how her patellas have developedPet Insured: YesHISTORY- colour dilution alopecia noted- Last heat cycle around November 15 2025- Luxating patellas observed, with occasional skipping, especially when running or on tiles, sometimes lifts 1 leg or leans to one side while eating. Both Os seem to think it's the LHL that is the problem.EXAMBARDG  0 - all adult dentition, no deciduous teeth leftBoth stifles - still gr2/4 MLPAlopecia around the head - skin NAD, not dryHeart sounds clearNon-reducible umbilical hernia present DIAGNOSIS- Fit for vacc- colour dilution alopecia- Luxating patellasPLAN1. C5 given today2. Book spaying procedure in about 4 weeks3. Monitor frequency of skipping and consider surgical intervention for patellas if condition worsens4. Lifestyle management to minimize vigorous activities that could exacerbate patella issues    Vital Signs    Weight: 4.5;       

Appointment Reason: Teeth, Appointment Notes: frequent urination, peeing in the house which isn't like her, told to come in with a urine sample. cv Paws App Details:Booking Type: Consultation (skin, eye, ear, multiple)Booking Vet: - Any -Booking Notes: Junie is irritated when peeing and urinating more frequently and abnormally. Also want to check how her teeth have grown in, and am concerned that she she sways to the side when she runs. History: trying to get at her back end from time to time; O not sure if vulva or anusNoticed yellow discharge from vulva yesterday ; urinated a lot at the park yesterday and urinated twice in the morning which is not normal Wanting to check how teeth growing in O not hearing any clicking of knees nowappetite normal; no lethargy, no vomiting, normal faecesHopping / Skipping from time to time on back legs when trotting Assessment: - retained upper deciduous canines (should be corrected soon to avoid issues with the adult canines)- umbilical hernia (non-urgent; O not planning to spay till she is 12-18 mo age so can be done at same time as spay) - bilateral Grade 2 luxating patellaPlan: No luck collecting urine sample during consult; taking home sample collection -pot and will try to collect and drop off tomorrow Book in for deciduous canine extraction under GA 09/12/2025 11:49:44 AM jh:called re overdue vacc and check up     Vital Signs    Weight: 4 (Patient Update);       MMColour: Pink;       HeadEyes: Normal;       Nose: Normal;       Skin: Normal;       MusculoSkeletal: Abnormal (bilateral grade 2 luxating patella);       Ears: Normal;       Neck: Normal;       LymphNodes: Normal;       Heart: Normal;       Lungs: Normal;       Abdomen: Abnormal (non-reducible small umbilical hernia );       RectalGenetalia: Abnormal (mild yellow mucoid discharge stuck at tip of vulva; no swelling or inflammation noted on outside);       Demeanour: BAR;       Hydration: Normal;       Gingivitis: 0;       Calculus: 0;       Observation: Abnormal (bilateral upper retained deciduous canines);       Temperature: 38.3;       RespirationRate: 36;       HeartRate: 140;       BodyScore: 5;       PainScore: 0;       CRT: 1-2;       

Appointment Reason: Vaccination, Appointment Notes: Paws App Details:Booking Type: Vaccination & Health CheckBooking Vet: - Any -Booking Notes: June needs her third/final puppy vaccinationPet Insured: NoSpot on back of her neck, noticed it on Sat, not changing in size, not bothering her. Very clicky back legs, especially when she jumps, not limping. No diarrhoea, would do dry retch in the evening if she's hungry. Doesn't eat breakfast sometimes. Sneezes occasionally, discharge coming out of her vagina but not bothering her. No PUPD. Flea and worm: Simperica trio given 8/9. Diet: Prime 100 airdry biscuit and Ziwipeak; bigdog raw; Mini RC. CE- TRP wnl BCS 4/9- Ears, nose, eyes clear- Oral: deciduous teeth. LL canine slightly pinching upper gum- Heart and lungs clear- Abdo: 1cm umbilical hernia not reducible- Skin: a few scabby smalls skin lesion behind neck and on top of head, minimum inflammation, no infection - MSK ambulatory x 4; mild click on L hip extension. Both patella very looseAssessment- Fit for vaccination - Slightly mouthy- LL deciduous canine mildly irritating upper gumTx- C4 SCPlan- O to monitor for PUPD, if noticing she's irritated around her backend or PUPD bring in urine sample - Training to discourage mouthy behaviour. - Review teeth, hernia and HLs/hips in 6 months of age. - Aim to desex >6mth of age.     Vital Signs    Weight: 3;