C10004009 / invoice 10000

gingivitis significantly improved good weight gainnail trimO going to get orivet genetic testing for peace of mind

H: O emailed some notes after the consult: Breath stinky Nasal discharge significant improvement but still seems like I need to give it a wipe after crusting onto nose. Teeth improved more keen to eat dry food and especially very gritty chunks. Keeps shaking his left paw for some reason Breathing still laboured Makes honking and wheezing noses not at rest Very loud breathing when at rest. Sounds strained breathing through nose. Sounds like someone breathing through inflamed nose/nasal canal after a cold or broken nose. Less active than when he first finished antibiotics but seems far more himself than he was prior to antibiotics. Bit lazy again with play far less energetic.  seems much happier and more outgoing since finishing vibravetplaying lots with his brother still has lots of loud breathing - seems positional- never open mouth - not associated with exercise RC/hills kitten with a variety of toppers: freeze dried mussels, meat, freeze dried meat - see note in files for full list S: Eyes: Normal  Ears: Normal  Nose: NormalMouth: gingivitis almost completely resolved Skin and S/C: NormalMusculoskeletal: NormalThoracic Auscultation: increased upper resp sounds, changes with head/neck positioningno increase in effortbreathing through is nose normally Abdominal Palpation: Normal, comfortable Neuro: NormalO: HR 184, RR 28, MM pink, CRT 1-2sec, Pulses NormalA: gingivitis mostly resolvedno big concern with increased resp sounds at the moment. T: cuddles P: continue to monitor breathing sounds. seems quite positional at the moment. may resolve with growth as he has had some awkward growth spurts

H: Eating normally and drinking normallyconcerns:worried he's overweight has increased upper resp sounds, inspiratory from O's videosdental healthRC kitten and feline naturals freeze dried, tripe - doesn't like dry foodS: Eyes: Normal Ears: Normal  Nose: Normal, sl crusty nasal discharge Mouth: moderate tartar upper PM4's and lower M1's Skin and S/C: NormalMusculoskeletal: NormalThoracic Auscultation: Normal heart and lung soundssl increased upper resp volume on inspirationAbdominal Palpation: Normal, comfortable Neuro: NormalO: HR 184, RR 28, MM pink, CRT 1-2sec, Pulses NormalA: mild juvenile periodontitis intermittent stertor T: none in consult P: disp vibravet, 2 week course (1 notch SID after loading dose) for gingivitis and possible mild cat flu signs. recheck when finished medicationmay need dental S&P if gingivitis persists.