C10004730 / invoice 10000

off food for 3-4 days. panting a lot since last night. o hasn't fed the dog this morning. no V+. no D+. not on any meds. 

BAR. panting but no dypnoea. dental horrible. all superficial LN wnl. skin tent wnl. HR160bpm. RR90/panting. clear chest sound. BT 39.6. rectal- empty and moist. ate liver treats in the consult. obese. abd palpation was challenging because of the dog's size. i think i can feel an abd mass in mid abd. no fluid wave. 

panting, not eating well which is very unusual for her

i am worried there is an abd tumour that is bleeding so i advised a blood test. blood showed mild regenerative aneamia with high CRP. 
discussed abd ultrasound +/- chest xrays. o is keen to have abd ultrasound done with CL on Tues. I will send CL a msg and confirm with o tomorrow. 
in the mean time, o to monitor closely - monitor her gum colour or her conjunctiva colour. monitor her behaviour too. if she gets worse, o will take her to PCEV immediately to get a quick ultrasound done and to repeat PCV. no medication needed at this stage but o just need to be aware of possible ongoing bleeding. 

blood smear- neutrophils all are segmented with dots, monocytes also have lots of dots?
PCV= 36

in for vax
brought in with other dog
is shy, reluctant to allow examination but well behaved
EDUF OK 
apparently greedy dog - will eat other retrievers food if gets the chance - is carrying 5 kg too much
O finds walking her long distance is difficult as cant go without other dog, which is older and cant go as far
weight is an issue - all feed are sl splayed and consequenht nail contact with ground id imnpaired - all nails are long
has grade 3-4 dental disease - really needs a COHAT - apparently owners (both medicos) are concerned re GA risk - will only get worse the longer it is neglected
otherwise OK
nails clipped
heart and lungs sound OK
abdo palpation unremarkable other than multiple large lipoma - previously diagnosed
KC vax given