C10003171 / invoice 10000

Appointment Notes: litter aversion lmrmoved from east malvern - 2 mnths ago (9571 1404)last vacc in book sept 24 (due sept 25) unless had but not taken book- ring to check plbeeen reas healthy all lifeindoor catsame litter as always- always used box but now started going outside litter tray, init jut defaec, now also urinationnly one cat in household, two litter in same  roomcleaning pretty much as soon as been to toiletstill v happy in herselfstarted about one month agoO- lovely catpain on palpation of sacrum- repeatablealso resents lifting  tail to take temp, so temp not takenA- anxiety with litter tray dt pain of sacrumvs not high enough standards of clean litter trayP- try extra trays and diff littera;lso meloxicam trial for back painback if not improvementring with progressLMR to ring check when vacc due, if overdue arrange rv and vacc in 2 weeks    Vital Signs    Weight: 4.8;       MMColour: Pink;       HeartRate: 160;       BodyScore: 5;       CRT: 1-2;