C10003085 / invoice 10000

Reason: Fit For BoardingSubjective: No concernsGrade 4 murmerIncr resp effort in clinic todaySeems hard to see breathing when asleepCrodisure 1/2 BIDCodien 1/4 BIDFrusemid 1/4 BIDNo recent chck of resting RRDAD and cardiomegaly on rads month4 cyt dailyName of medication (including concentration) - Codeine 20mg (O has asked if we can please cut up into 1/4 tablets) How much and how often is it being given - 1/4 tablet BIDQuantity requested - 20sName of medication (including concentration) - Frusemide 20mg How much and how often is it being given - 1/4 BID Quantity requested -  30Verified: NoReason: History:In good health according to ownerNormal EDUDPersistent cough ongoing - described as old dog airway tickle coughStill active and playful with moments of energyDaily walks with ownerCurrent medications: Cardisure 1/2 tablet morning and night, Conyil 1/4 tablet morning and night, Frusemide 1/4 tablet morning and night, 4Cyte 5mL on food in morning for OARecent dental procedure with chest X-rays less than one month agoExamination:BAR in consultMMs: pink & moist, CRT < 2secEars: No odour or significant dischargeHR: 120Cardio: Grade 4 heart murmur, crackles on auscultationResp: Coughing present, crackles audible - consistent with dynamic airway dz rather than congestive heart failureAbdo: comfortable on palpation, no palpable massesMSK: Mild stiffness on front L foot when rising, responds well to massage, still mobile and activeIntegument: NADLNs: normalLaboratory:RADIOGRAPHS: Recent chest X-rays showed big heart, dynamic airway dz, compensated cardiac dz, no fluid on lungsAssessment:Compensated cardiac dz on medication - stableDynamic airway dz causing cough - not congestive heart failureEarly stage kidney dzOA - mild, well managedPlan:Cardisure 1/2 tablet BID ongoingFrusemide 1/4 tablet BID ongoing - may increase to TID if respiratory rate increases4Cyte 5mL SID ongoing for OADispensed: Cardisure tablets x20, Frusemide tablets x30 (to be cut into quarters)Conversation with owner:Owner to monitor respiratory rate at home - count for 15 seconds, multiply by 4, should be less than 30 breaths per minuteIf respiratory rate increases, contact clinic as may need to increase Frusemide frequencyDiscussed boarding options and home care alternatives for upcoming travelAdvised cardiac dz is stable but requires ongoing monitoring and medication    Vital Signs    Weight: 4.8;