C10009994 / invoice 10000

Reason: SneezingHistory: Sneeing & eyes settled with doxy Mucky eyes have gone mucky Sneezing lots again, 10-12 in a row Nto snoring any more Sneezing clear liquid Appetite fine Drinking lots No vomiting/diarrhoea Examine: BARMM pink, refill <2sDG 1-2/4Eyes - bilateral epiphora, no erythemaEars nsfNose - no nasal discharge, few sneezes in consult PLNs wnl, submandibular LNs wnl CV Poss somewhat repeatedly sensitive around palpation of 204 but no obvious swelling and resposne not truly consistent Assessment: Plan:Repeat tx trial doxy + zyrtec antihistamine If recurs after this then need to reconsider further investigation, may become a QOL issue.    Vital Signs    Weight: 7;       

Reason: Thinks Has A Cold/rubbing EyeHistory: right eye a bit mucky, O cleaning out twice a day. Not green/yellow or sticky. Just seems like wetter sleep. Starting to sound like a pug. Been sneezing whole body sneezes. Breathing sounds different. 2-3 days. Has never snored before - now snoring.Drinking a ton and urinates a lot. Gets up 2-3x a night to wee but this is normal. Cognitive decline - once a week has a bad night - pacing overnight and can't be comforted. Had a bad time on fluoxetine - took him off this and became good again. O hasn't started selegiline but will give a try. Examine: BAR, mm pink moist CRT<1s. HR120 grade 3/6 SHM, difficult to hear above the panting. Lung sounds clear. No nasal or ocular discharge. Both eyes are open and comfortable. No redness. No pain on palpation of maxilla. Oral exam - few teeth remaining - only upper canine and incisors remain of the Right maxilla.Assessment: URT noise/ sneezing ddx infectious, inflammatory, neoplasia etc. O unlikely to go for diagnostics/ imaging which is fair in a dog of his age. Cognitive decline. Have not tried selegiline yet. O will start after overseas trip. In the meantime to use trazodone for once a week overnight distress. Plan: trial doxycycline 75mg PO SID for 8 days.  Trazdone 50mg PO for nights in distress. Script written for Plan to start selegiline 5mg (1 tab) once a day for a week then increase to 7.5mg (1.5 tabs) once a day as per Georgina Child. PrescriptionTHIS PRESCRIPTION IS FOR ANIMAL TREATMENT ONLYThis prescription is not covered by the PBS or MedicareOwner:	Ms K Longhurst41 Palmer Street  BalmainNSW    2041Patient:	AceSex:Male Neutered Details:	White     Maltese CrossSpecies:DogDate of issue:19/02/2026	       Reference    1023182	Prescription Expiry date:19/08/2026Medication: selegiline Form: 5mg tablets Quantity: 100 tablets Instructions: Give 1 tablet once a day for a week, then increase to 1.5 tablets once a day ongoing. Repeats Authorised:1Patients must have had a Standard Veterinary consultation within the previous six months for ALL written prescriptions. Some medications will require a more frequent recheck interval.Fee for Lost Prescription is $15.Dr Angela Camilleri V9533  for Balmain Veterinary Hospital    Vital Signs    Weight: 7.1;       HeartRate: 120;       

Owner would like spot on for this treatment May consider injection again next time due    Vital Signs