C10004002 / invoice 10000

Reason: Cat is not eating well and not as active

History:
2 days ago not interested in playing, lying down after a few steps, bum/back up - possible sore stomach?
reduced appetite 2 days
better today - eating more today, giving wet food, more energetic
no V+
likes to bite rubber, no known ingestion
other kitten fine
poo more soft 2 days ago

Vital Signs:
Temperature: 38.1C
Heart Rate: 200 bpm 
Pulse rate: 200
Pulse character: strong and synchronous. 
Respiration Rate: wnl 
MM: pm 
CRT: <2 sec

PHYSICAL EXAMINATION:
Appearance: BAR; BCS 3/5
Eyes: nad
Ears: nad
Nose: nad
Oral Cavity: nad no ulcers or string under tongue
Heart / Lungs:eupnoeic , no dyspnoea, normal bronchovesicular sounds
Abdomen: nad formed faeces in colon
Musculoskeletal: ambulatory no back pain, curious and jumping off table in consult
Neurological: neuro exam not performed
Integument: nad 
Peripheral LNs: nad
Urogenital: nad
Rectal exam: not performed 

Assessment/Problem List:
reduced appetite and energy - resolving ddx viral, partial foreign body, dietary indiscretion etc 

o declined further testing and happy to monitor 
recheck if worse/no better
can dispense prokolin, GI food it D+ persists

Plan:
recheck if worse/no better

Reason: 3rd kitten vaccination

History:
EDDU well, no CVSD
Both cats have been licking their shoulders more than usual
Otherwise no health concerns
UTD NGS last given at last vax, milbemax given in december. 

Vital Signs:
Temperature:  not taken
Heart Rate: 160  bpm 
Pulse rate:  160
Pulse character: strong and synchronous. 
Respiration Rate: 44. 
MM: pink, moist
CRT: <1 sec

Dehydration assessment: Euhydrated MM moist no skin tent

PHYSICAL EXAMINATION:
Appearance: BAR; BCS 3/5
Eyes: nad. no redness, discharge, blepharospasm. responds to visual stimulus
Ears: nad. no debris or inflammation
Nose: nad
Oral Cavity: nad. juvenille teeth present
Cardiovascular: Auscultation no murmur detected ,pulse quality normal ,rhythm regular
Respiratory: RE normal , auscultation normal
Abdomen: soft and comfortable
Musculoskeletal: ambulatory all 4 limbs
Neurological: appropriate mentation
Integument: free of ectoparasites or other skin lesion
Peripheral LNs:Normal size, symmetrical
Urogenital: not assessed
Rectal exam: not examined

Assessment/Problem List:
1. Fit for vaccination

Treatment:
Fel-O-Vac F3 sc
NGS applied to back of neck

Plan:
F3 due in 1 year
NGS monthly
Milbemax due in march
OK to desex anytime - recommend under 4mo with counsel regulations

Monitor licking behaviour after NGS, poss behaviuoral/stress vs. pruritus vs. pain. Discussed feliway multicat. 

vaccination

doing well
 no concerns
vitals wnl
PE unremarkable
 male entire 
Fel O Vax F3 sc 
FREE NGS applied