C10007861 / invoice 10000

Reason: Cartrophen Inj & Nails Appointment Notes: will have had Traz monday night and 2hrs before visit today AwHistory: Had 200mg traz last night ~6pm and ~ 7am this morning- a little spacey last night and this am.- still quite anxious- have started to have cartrophen earlier as getting more lame- has metacam at home EOD if sore.- EDUD wnl, well at home otherwise- didnt have evening poo as usual last night post trazodoneDiet: on green lipped mussel + RC joint foodAlso concern about irritation on elbows - mainly Left elbowExamination: BAR, still a little nervousINTEG: healthy coat. Has few small areas ~ 3-4mm diameter hairless red papule like lesions, no purulent discharge evident. Possible from pressure lying on cooler surfaces?  - see photos (taken L and R elbow)- Also small lump lateral digit 5 McPh region, had for a while on Q, soft/fluctuant? ~ 2cm diameter, non painful - see photosUnable to trim nails - still v. Nervous, managed L dew claw todayTreatment: Cartrophen SC dorsal neckPlan: - chlorhex BID elbow + strengthening biobalm or NAS dermal cream, INI cytology along with mass at next consult - impression smear vs other as indicated- add in gabapentin 10mg/kg in am with traz + traz night before as well- come back for FNA mass L paw + trial nail trim- also discussed going in trial for Arthramid at VSS for ED Left elbow (had Sx there when younger), will contact VSS and discuss    Vital Signs    Weight: 38.3;