C10005056 / invoice 20000

Reason: Beransa Recheck KC Last Week Appointment Notes: Special payment terms exist  ------- Sms reply: YPresenting Complaint:Hx: Current Meds:PE:        Mouth:    CVS:    Resp:    Abdo:    MSK:    Neuro:    EENT:    LN:    Skin:    UroGen:    Rectal:Problem List: DDx:Beransa 15mg 813176 08/26Tx/Plan:Dx:Recheck Kennel cough - improving. Beransa boosterClient Communications:Follow-up:    Vital Signs    

Reason: Poss KCAppointment Notes: Booked for Beransa Inj on Monday and woudl like today if poss but knows may be done after dog is better. Please put through insurance. O to ring at lunch and pay over phone as son bringing dog in. Ok'd by KO. KOPresenting Complaint:Hx: Coughing since tues/wed Bit quiet at homeStill EDDU normalCurrent Meds: meloxicam PRN, beransa, cartrophen PE:        Mouth: NE     CVS: no murmur    Resp: normal bvs/effort    Abdo: tense but non painful     MSK: ambulating well today     Neuro: NAD    EENT: clear - no tracheal pinch but coughed when pulling on lead with dry hacking non productive cough     LN: WNL     Skin: NAD    UroGen: NAD    Rectal: NEProblem List: CoughingMild lethargy DDx:Cough sounds like tracheitis - plan to terat as if KC and monitorTx/Plan:Recheck Monday and if no improvement we can consider PCR/Chest xrays or Abs If back to normal ok for beransa Monday Meloxicam for 3 days this weekened Dx:Client Communications:Check up today for a dry throaty cough, which sounds like kennel cough (tracheitis).Rest this weekend - no walks and please prevent contact with other dogs as it is contagiousOffer soft moist foods and lots of fresh waterNormal vitals and temperature today, so no need to start medicationsShe may receive meloxicam for 3 days to help with throat painFinally, no beransa today to reduce impact on her immune system - plan to recheck Monday and ok for Beransa if she is back to normal Follow-up:    Vital Signs