C10010564 / invoice 10000

Reason: GHC - Excessive Panting Appointment Notes: O is concerned about the excessive panting even at night with aircon on etc. - kb8  ------- Sms reply: YHx: Previous health hx: -skin allergies, managing with cytopoint inj & medicated shampooO noticed some excessive panting when he sleeps, Wakes O up, only happened a few times.Previously found some stiffness in hip joint. Otherwise well at home, utd with vaccEx:Skin & coat maintained in good conditionClear bronchovesicular sound, no HM or arrhythmiaComfortable abdomen, soft to palpateBilateral hip joints sensitive with extension during exam R>L, however very strong dog, a bit hard to push the limb if he is resisting Ambulating well x 4 no lamenessA:Skin allergy managed well recently with cytopoint & shampooSuspicious of hip dysplasia due to breed. Explained the assessment of diagnosis will require radiographsExcessive panting can be from temperature, stress, pain/discomfort, CV disease, etc. Consider PE normal, open conclusion for now. O not too concerned considering PE findings normal, will keep monitor at homePlan:Continue monthly cytopoint or when required & mediderm shampoo to maintain skin health, will dispense more todayContinue oral hygiene routineStart joint supplements like 4cyte, monitor for any deterioration of joints. Consider imaging    Vital Signs    Weight: 37.8;       HeartRate: 96;       DentalGrade: <1;       RespirationRate: pant lightly;       PainScore: 0;       CRT: 1s;       MMColour: pm;       BodyScore: 5/9;