C10000953 / invoice 10000

Reason: Lumps On Face Appointment Notes: happy to see anyone (aware VA might see dog & SK come in and do discharge on other dog)History: Owners concerned lump on face right side below eye Reason for consultation:-- Duration:----Any other issues:Up to date with prevention:       -- yes/no -       -- type - Medications on currently - Examine:-- BCS: -- Temp: 38.4 -- MM:  pink-- CRT: 2 secs-- Cardiovascular:      -- HR:     -- No obvious murmurs or arrhythmias     -- or murmur - grade -  -- Respiratory:     -- RR:      -- Respiratory effort - No increased insp or exp effort     -- Respiratory sounds - Normal bronchiovesicular lung sounds     ---- Abdomen:     -- Pliable, not painful, no masses obvious on palpation    ---- Oral:    -- Examination:    -- Dental score: -- Eyes:     -- No abnormal ocular discharge,    -- No conjunctivitis    -- normal sclera,     -- Pupils symmetrical.     -- Retinal examination normal.     -- Lens normal position and normal opacity.     -- Eyelids normal-- Nose:     -- Normal confirmation or brachycephalic    -- No sneezing.     -- No nasal discharge.     -- Normal symmetry. -- Integument:     -- Clean coat,     -- No dermatitis or skin lesions present.    -- Normal skin turgor    -- No fleas or externa parasites    ---- Ears     -- Left ear - normal canal with no discharge. Normal pinna    -- Right ear - normal canal with no discharge. Normal pinna-- Lymph Nodes:     -- all palpable external lymph nodes normal size and shape-- Musculoskeletal:     -- Ambulatory with no lameness.     -- Joints palpate normally.     -- Normal musculoskeletal exam    ---- Neurological:     -- Mentation - BAR.     -- Normal CN function.     -- No ataxia noted.     -- Normal neurological exam     ---- Rectal exam: -- Reproductive:     -- n/a (de-sexed)     -- or normal reproductive examination     -- or prostate/testicles/penis normal    -- or vulva/mammary tissue normal -- Behaviour: Swelling right side of face below eye Right upper carnasial tooth lateral slab fracture gumline isnt red or inflammed --right upper carnasial tooth swelling under eye concerned tooth root abscess as slab fracture but no discharge or gumline inflammation  -- slab fractured upper carnasial teeth left side mild but right side more tooth erosion Problem list: 1.Tooth root abscess right upper carnasial 2.Potential for tooth root abscess left upper carnasial tooth 3.Plan: Discussed likely tooth root abscess and quoted for dental 1500 to 1800 right upper extraction possible left upper carnasial extraction Will provide anti histamine in case allergic bite reaction but unlikjely Assessment: Swelling right side of the face below eye Differential Diagnosis: Tooth root abscess Insect bite reaction Neoplasia Diagnosis:Tooth root abscess likeloy Treatment:Rec get in for dental owners cost constrained will book in if poor resolution Clav 250mg 1 bid Niramine 1.2ml SC Subjective:- Lumps on face, noticed this morning- Mild swelling, not present this morning- No change in appetite (variable at baseline)- No trouble eating noted- No swelling of eyelids or other facial areas- No other changes from normal behaviourPast Medical History:- Previous chip in tooth noted at last visitObjective:- Temperature: 39.5°C (elevated, high normal upper 38s)- Weight: 11-12 kg- Oral examination: Fracture to carnassial tooth on left side; similar appearance on right side with slight fracture; no redness above gum line; no pus expressed on palpation of gum lineAssessment:- Suspected tooth root abscess (approximately 90% likelihood)- Differential diagnosis: Insect bite reactionPlan:- Antihistamine injection administered- Antibiotic tablets: one tablet twice daily- Monitor closely; swelling may reduce on antibiotics then flare when course completed- If swelling recurs after antibiotics, supportive of tooth root abscess- Dental procedure may be required in future: anaesthesia, tooth assessment, possible extraction of carnassial tooth (estimated cost $1500-1800); may need to consider removal of contralateral carnassial tooth due to fracture- Owner to contact insurance company regarding coverage    Vital Signs    Weight: 11.2;       Temperature: 39.5;       

Reason: Possible Ripped DewclawHistory: Reason for consultation:-- Duration: wound on interweb area of the RTL - between digits 3-4 - just happened in past 24hrs. Prior Hx Fractured pelvis with ilial shaft fracture- plate and screws - repaired 3 years ago, occurred secondary to BDLD dog attack. --takes meloxicam 0.6ml PO SID prn occasionally for this. Last dose was 3-4 days ago.--Up to date with prevention: ?  Not on record of vaccinations etc here Medications on currently - meloxicam 72hrs ago  Examine:-- BCS:  6.5/9 - overweight -- Temp: 39.5-- MM:  pink-- CRT: 2 secs-- Cardiovascular:      -- HR: 128    -- No obvious murmurs or arrhythmias -- Respiratory:     -- RR:   panting     -- Respiratory effort - No increased insp or exp effort     -- Respiratory sounds - Normal bronchiovesicular lung sounds     ---- Abdomen:     -- Pliable, not painful, no masses obvious on palpation    ---- Oral:    -- Examination: some tartar     -- Dental score:  2/4 -- Eyes:     -- No abnormal ocular discharge,    -- No conjunctivitis    -- normal sclera,     -- Pupils symmetrical.     -- Retinal examination normal.     -- Lens normal position and normal opacity.     -- Eyelids normal-- Nose:     -- Normal confirmation    -- No sneezing.     -- No nasal discharge.     -- Normal symmetry. -- Integument:     -- Clean coat,     -- No dermatitis or skin lesions present over truncal areas     -- Normal skin turgor    -- No fleas or externa parasites    -- some salivary staining to all four feet  -- interweb digit 3-4 RTL open sinus tract with purulent exudate. Cleaned with betadine -- Ears     -- Left ear - normal canal with no discharge. Normal pinna    -- Right ear - normal canal with no discharge. Normal pinna-- Lymph Nodes:     -- all palpable external lymph nodes normal size and shape-- Musculoskeletal:     -- Ambulatory with lameness grade 2/4 RTL and 1/4 RHL     -- Joints palpate normally.     -- Normal musculoskeletal exam    ---- Neurological:     -- Mentation - BAR.     -- Normal CN function.     -- No ataxia noted.     -- Normal neurological exam     ---- Rectal exam: -- Reproductive:     -- n/a (de-sexed) -- Behaviour: -- -- Problem list: 1. Wound between digits 3-4 on RTL DDX grass seed abscess vs other interdigital furunculosis , neoplasia etc Plan: Amoxyclav 250mg BID 10 days Meloxicam 0.6ml PO SID 5 days prn therafter Revisit if not 100% may need GA and explore draining sinus tract.Laboratory: Assessment: Differential Diagnosis: Diagnosis:Treatment:Meloxicam 0.6ml PO SID 3-4 days    Vital Signs    Temperature: 39.5;       

Reason: Poss KC - Told To Call From Call When ArriveAppointment Notes: client requested to not be seen by DPHistory: Owners concerned dry hacking cough does go to dog park Reason for consultation:-- Duration:----Any other issues:Up to date with prevention:       -- yes/no -       -- type - Medications on currently - Examine:-- BCS: -- Temp: 38.4 -- MM:  pink-- CRT: 2 secs-- Cardiovascular:      -- HR:     -- No obvious murmurs or arrhythmias     -- or murmur - grade -  -- Respiratory:     -- RR:      -- Respiratory effort - No increased insp or exp effort     -- Respiratory sounds - Normal bronchiovesicular lung sounds     ---- Abdomen:     -- Pliable, not painful, no masses obvious on palpation    ---- Oral:    -- Examination:    -- Dental score: -- Eyes:     -- No abnormal ocular discharge,    -- No conjunctivitis    -- normal sclera,     -- Pupils symmetrical.     -- Retinal examination normal.     -- Lens normal position and normal opacity.     -- Eyelids normal-- Nose:     -- Normal confirmation or brachycephalic    -- No sneezing.     -- No nasal discharge.     -- Normal symmetry. -- Integument:     -- Clean coat,     -- No dermatitis or skin lesions present.    -- Normal skin turgor    -- No fleas or externa parasites    ---- Ears     -- Left ear - normal canal with no discharge. Normal pinna    -- Right ear - normal canal with no discharge. Normal pinna-- Lymph Nodes:     -- all palpable external lymph nodes normal size and shape-- Musculoskeletal:     -- Ambulatory with no lameness.     -- Joints palpate normally.     -- Normal musculoskeletal exam    ---- Neurological:     -- Mentation - BAR.     -- Normal CN function.     -- No ataxia noted.     -- Normal neurological exam     ---- Rectal exam: -- Reproductive:     -- n/a (de-sexed)     -- or normal reproductive examination     -- or prostate/testicles/penis normal    -- or vulva/mammary tissue normal -- Behaviour: -- unable to elecit cough on tracheal palpation -- tick search neg Problem list: 1.Coughing dry hacking productive 2.3.Plan: Treat kennel cough and assess response Laboratory: No bloods rec chest radiographs if continued coughing Assessment: Coughing Differential Diagnosis: Tracheitis Kennel cough Pharynghitis Neoplasia Rat sac Tick Diagnosis:Treat as kennel cough / tracheitis Treatment:Clav 250mg 1 bidLinctol 2.5ml 2 to 3 times a day Subjective:- Presenting complaint: Coughing (honking, choking-like)- Duration: Started yesterday- Associated symptoms: Bringing up phlegm- Other pets: 2 other dogs at home, not coughingPast Medical History:- On tick prevention- Previous episode of kennel cough (similar symptoms)Objective:- NADAssessment:- Likely kennel cough- Differentials: Tracheitis, oesophageal foreign bodyPlan:- Antibiotics: 1 tablet twice daily without food- Cough mixture: 2.5 mL 2-3 times daily- Advised:- Kennel cough self-limiting, typically improves in 5-7 days- Monitor other dogs for similar symptoms- Can use cough mixture for other dogs if symptoms develop- Delay vaccinations until coughing settles- Consider large bones or plant-based chews (e.g. Greenies) for dental health- Follow-up: Return for vaccinations when coughing resolves (for all 3 dogs)    Vital Signs    Weight: 11.6;