C10006598 / invoice 10000

Reason: Skin IssuesAppointment Notes: Groomer noticed the skin is looking red and itchy in one spot. Unsure if it is a hot spotDAHistory: Went to groomer today, some pruritic patches of dermatitis notedOtherwise well Examine: BARPatchy areas of dermatitis tail and body Treatment: Cytopoint 30mg SC once Plan: Mediderm shampoo topically EOD 2 weeksCephalexin 2 week course    Vital Signs    Weight: 24.4;       

Reason: Vaccination And MedsAppointment Notes: Overdue reminders ADHistory:Going well, needing Carprofen and Gabapentin for RHL Has some pruritus on the ventrum Examination:Mentation: BAR, BCS 6/9Peripheral LN: WNLTeeth: 0/4 Cardiovascular: no murmurs or arrhythmiasPR = HR 120Respiratory: no adventitious lung soundsGastrointestinal: soft and comfortable abdo palpationMusculoskeletal:  normal gait, full msk exam not performedIntegument: ventrum has multifocal raised epidermal collarettes Urogenital: WNLAssessment: Fit to vacVentrum pyoderma Treatment:Vaccination: Pi2 subcut, oral BB Amoxyclav 500mg PO BID Carprofen 50mg PO SID long term Gabapentin 300mg PO BID Plan:KC vac given, along with the repeat medications    Vital Signs    Weight: 24.2;       

Reason: RHL LamenessAppointment Notes: Overdue remindersHistory:Os came home on Sunday and found him acutely lame on RHLNormally on ½x 100mg carprofen SID. O has been given 1 x 100mg carprofen BID (total 200mg per day) for the past few days but it has not helped.Is still bright, happy and EDUD normallyKnown medical problems, poss brain tumour? O not keen to investigate and also not keen on GA or surgery given this problem. Examine: Mentation: BAR, lovely boy as usualMM: Pink, moist CRT:<2sEENO: Bilateral ocular diz as before, blind. Left medial canthus mild abrasion Dental: 0/4HR: =PR=120Skin:  NSFMSK: Toe touching to non-weight bearing lameness RHL. Increased laxity palpable right stifle, possible cranial drawer but hard to be certain as is sore and guards the stifle. Abdo: soft, comfortable.  LN: WNL Neuro: normal mentation. Normal CPs Ugen: NSF Assessment:Suspected right CCL ruptureIdeally GA + examine + xrays but not currently an option for Teddy Plan:Try medical management for now.Continue carprofen at 50mg BIDAdd in Gabpentin 300mg BID. Can have more if requiredAdd in Paracetamol 375mg BID.Strict rest and confinement and see if stifle will fibrosis up and provide some stability. Client communication: O is a prev remedial masseuse so does know about CCLs. Discussed medial vs surgical options. Discussed pathophys of CCL rupture.    Vital Signs    Weight: 23.5;