C09999951 / invoice 10000

Vet Summary of Path Results- bloods all normal P; advise owner if the V+ continues then will need xrays and ultrasound.SMS sentHey Faye, Tess's bloods are all NORMAL - which is Great - if she is still not right then will need to do more investigation with xrays and maybe an ultrasound of her abdomen - let us know how she is going tomorrow thanks Dr Rob Payne

eating - not normal eatingvomited - few times over the last week, 3-4 times in a weekno changes to her dietdiet: RC dermatology, and prime100? spoonful of wet foodno bones, occasional pigs ears and carrots energy levels seem the same - looking to playEHR 100bpm no murmur or arrhythmiaresp lung sounds cleareyes, nose, ears nsfteeth grade 1 PD diseasemm pink and moistabdo comfortable on palpationmsk nsfAvomiting ddx dietary indiscretion vs otherPfull bloods to check organ functiondiscussed potentially trialling different diet eg. delicate skin and stomach disp trazodone and gaba for pre visit sedatives for nails in future

 Yelped when did the 'shake' action with LF paw today - also yelped when owner touched the footNot limpingHas been licking at feet a bitHas history of skin issues -  has been licking at all four feetStopped the trazodone as she was too sedate on itHave tried adaptil spray and this has helped quite a bitOn vitB for her nails, no other medsExaminationHeart and lungs NADIntegument - mild erythema with ventral aspect of metatarsal area on both front paws. No pain on palpation of feet, nails sturdy, no dislocations or crepitus. AssessmentAllergies vs mild MSK injuryPlanTo trial hydrocortisone cream topically to area (owner already has at home)If not improving can add in metacam SID to trial for sprain, or apoquel BID (then reduce to SID) for allergies. Owner happy to take both of these options as clinic is closed over the next 4 days