C10006686 / invoice 10000

Primary Presenting Complaint - diarrhoea, vomiting
Other Complaint - 
         Loyalty Reward Program - Y/N
History - 
         Last Normal - soft stools friday, lethargic on saturday and not wanting to eat, sat d+++, sunday lethargic, cooked pumpkin + rice, today vomited + d+++ liquid, at scrabbled eggs today

dog roll with boar - single protein. 


         Frequency   -
         Last Ate       -
         Medicine Hx  - 4cyte, meloxicam (stopped yesterday), omega 3, 
         Diet              - combination of  steamed cooked veg- pumpkin, sweet potato, spinach, blueberries, chicken heart/ livers -raw, eggs, chicken necks,
         Vacc Current - 
         Worming Hx  -
         Heartworm    -
         Microchip       -  Y / N    -  scanned - ok?

Examination -
         Attitude - BAR
         Body Score -   4.5-5 /10
         Temperature - 38.1
         Heart -   HR. Murmur - 
         RR - wnl
         Dental - Score(0-4)=    .Comment
         CRT - 1.5s nice rosy pink
         Eyes - NVL
         Ears - clean and discharge free
         Abd Palpation - tense
         Gastrointestinal -  No Sig Findings
         Urogenital -  No Sig Findings
         Skin - nsf
         Musculoskeletal -  not assessed, managed for OA
         Neurological -  No Sig Findings
         Lymphatic - No Sig Findings
         Other key findings = 

Assessment - 
Problem List - d++ (lliquid), 1x vomit, inappetance.
DDx                 - gastro - bacterial, inflammatory, viral etc.
Discussed      - give recurring issue, consider commercial food options moving forward longer term rather than chopping and changing things too much.
Treatment Plan - 
- mtronidazole bid 5 days
- maropitant s/c 3.3ml
- i/d diet initially then consider delicate care + prime rolls longer term. 
- paracetamol to replace meloxicam for now until GIT resolved. 
- pro-kolin bid until stools firm (offset from metronidazole) 
Prescriptions(on-going) -
Next Visit            -

Primary Presenting Complaint - sore on back of paw, above pad - RH
Other Complaint - 
         Loyalty Reward Program - Y/N
History - 
         Last Normal - EDUF normal 
         Frequency   -
         Last Ate       -
         Medicine Hx  - Epiotic.  
         Diet              -
         Vacc Current -
         Worming Hx  -
         Heartworm    -
         Microchip       -  Y / N    -  scanned - ok?

yesterday was licking at it 

red  
this morning  been raw .  

rest skin going ok.  

otherwise  been going good .  

didnt need any extractions from drovers at dental .   recovered abit slow after GA  but otherwise did well 


Examination -
         Attitude -  BAR 
         Body Score -    6 /10
         Temperature -  not indicated 
         Heart -   HR. Murmur - none heard 
         RR -  24 
         Dental - Score(0-4)=  0  .Comment
         CRT - 1.5 sec 
         Eyes - NVL
         Ears - mild brown discharge   and mild erythema .  o declined cytology .  o would like dex added to epiotic as done in past. 
         Abd Palpation - Unremarkable
         Gastrointestinal -  No Sig Findings
         Urogenital -  No Sig Findings
         Skin -   R hind lateral aspect of above carpal pad ~2 cm area of alopecia and dermatitis .  been licked raw 
         Musculoskeletal -  No Sig Findings
         Neurological -  No Sig Findings
         Lymphatic - No Sig Findings
         Other key findings = 

Assessment - likely hot spot 
Problem List - dog been licking ,  focal area of dermatitis with superficial infection 
Discussed      -  trial neocort  - cant lick off for ~30 mins  otherwise wont work .   prevent dog from licking also .   might need apoquel  - o will call if still licking and get some 
Treatment Plan -   neocort  ,  o wish to bandage for 1 hr post put neocort on so given melanin + vetwrap .     5ml 5mg/ml dex added to o ~250ml of epiotic he brought in 
Prescriptions(on-going) -  apoquel , melox  6month 
Next Visit            -  as required