C10000902 / invoice 10000

Reason: Mouth Sore, Unable To Eat.History: Wants to eat and foes to the bowlPicks up some food/llicks, growls and runs off Past few days Salivating a little Not rubbing Not seen drinking for 24 hours Quieter than normal Normally great appetite Diet - wet and dry No v/d/s/cUnintentional weight Indoor and outdoor Examine: lost 500g in 3 yearsMm pink, grade 3 dental dzCannot open mouth to check for oral lesions - swiping ++SM LN enlarged, some saliva staining LHS of the mouth Purring ++ HR 140, cannot ausc for murmur NAD abdo palp Assessment: advanced dental dz - cause of the oral pain? Advised owner cannot exclude other causes such as neoplasia - will need to check once under GA Discussed weight loss also - will need to get bloods on the day as too spicy to do today without sedation Discussed hx of murmur - was due repeat echo in august 25. Recommend echo prior to GA - will need to do dental another day. Owner declined repeat echo prior to GA - aware of the increased risk but given so painful he needs procedure regardless Treatment: buprenorphine PO BID vs TID Plan:Do not give buprenrophine on monday $1600-2400Gaba to be given night before and AM of    Vital Signs    Weight: 3.63;