C10010677 / invoice 10000

TEMP: 39.8
WEIGHT: 3.87
HISTORY: Appt notes: Went outside at 3am, came in as normal. Went out at 6.30 and came in acting bizarre (O has video). No vomiting, no diarrhoea. Pest control yesterday came out and sprayed, took dogs out for 2 hours as per recommendations.KRS: O shoes video of Toby being bright and alert, but keeps sitting on back end and doing odd stamping actions with front limbs. O is certain this is not normal behaviour for him. Possibly a bit quiet yesterday but has been otherwise well. EDUD normal. No vomiting/diarrhoea/strangiuria. No collapse or lethargy - if anything is hyperactive. Human medication out of access to all pets.
ER - In waiting room seemed unsettled/agitated, would randomly start reversing, and startle like something biting him. Also seen to be scooting and licking front paw (wasn't too keen on me looking).
CLIN_EXAM: BAR, friendly bit anxious. CVS and resp wnl. MM slightly inflamed, moist. CRT 1.5s. Hyperthermic. Abdo: No palpable abnormalities or discomfort. Integument: Wet front paws (excessively licking). Lick stains all feet. No torn nails, no stingers or bites found.
EEND: Severe brachygnathia. Mandibular canines not in contact with maxillary dentition or upper hard palate. Dense build up of hair in ear canals. No pain on palpation
MSK: No gait abnormalities but on two isolated occassions did 'stamping' actions with front. Wanting to sit 
EAG: Moderately full and easily expressible anal glands. 
Neuro: No CP deficits. Normal gait. Can walk in a straight line. Vision present. Dilated pupils with minimal PLR (But Toby is currently very anxious). Very mild right side head tilt.
TREATMENT: Ddx: Allergic reaction - environmental allergies, contact allergies, insect bite reaction
0.5ml Dexason IM. Hospitalized for monitoring. Temperature reduced to 39.6 but Toby continues to be anxious if no one stays with him (anxiety reduced when is held/pat). No decline in symptoms but has continued to lick front paws. Repeat assessment have not been able to find a bite/stinger etc
Recommend parasite control
HEART: 160

HISTORY: Appt notes: Went outside at 3am, came in as normal. Went out at 6.30 and came in acting bizarre (O has video). No vomiting, no diarrhoea. Pest control yesterday came out and sprayed, took dogs out for 2 hours as per recommendations.
KRS: O shoes video of Toby being bright and alert, but keeps sitting on back end and doing odd stamping actions with front limbs. O is certain this is not normal behaviour for him. Possibly a bit quiet yesterday but has been otherwise well. EDUD normal. No vomiting/diarrhoea/strangiuria. No collapse or lethargy - if anything is hyperactive. Human medication out of access to all pets.
CLIN_EXAM: ER - In waiting room seemed unsettled/agitated, would randomly start reversing, and startle like something biting him. Also seen to be scooting and licking front paw (wasn't too keen on me looking). 
KRS: 
BAR, friendly bit anxious. CVS and resp wnl. MM slightly inflamed, moist. CRT 1.5s. Hyperthermic. Abdo: No palpable abnormalities or discomfort. Integument: Wet front paws (excessively licking). Lick stains all feet. No torn nails, no stingers or bites found.
EEND: Severe brachygnathia. Mandibular canines not in contact with maxillary dentition or upper hard palate. Dense build up of hair in ear canals. No pain on palpation
MSK: No gait abnormalities but on two isolated occassions did 'stamping' actions with front. Wanting to sit 
EAG: Moderately full and easily expressible anal glands. 
Neuro: No CP deficits. Normal gait. Can walk in a straight line. Vision present. Dilated pupils with minimal PLR (But Toby is currently very anxious). Very mild right side head tilt. 
Ddx: Allergic reaction - environmental allergies, contact allergies, insect bite reaction
TEMP: 39.7
HEART: 140
TREATMENT: 0.5ml Dexason IM. Hospitalized for monitoring. Temperature reduced to 39.6 but Toby continues to be anxious if no one stays with him (anxiety reduced when is held/pat). No decline in symptoms but has continued to lick front paws. Repeat assessment have not been able to find a bite/stinger etc
Recommend parasite control
WEIGHT: 3.87

WEIGHT: 4.00
TEMP: 39
HEART: 160
RESP: 60
HISTORY: Appt notes: Due C5
Has been otherwise well
CLIN_EXAM: Owner says Toby has been bright and well, no vomiting or diarrhoea, sneezing or coughing. Does not go on walks as stays in a pram and plays a lot at home with other dogs in the yard. Sometimes will eat something he's not supposed to and vomits but rare occurrence.

Nervous, BAR, BCS 4/9 
Cardiac: Normal rhythm and rate on auscultation
Resp: Normal lung vesicular sounds dorsal and ventral quadrants. No nasal discharge.
EENT: Eyes clear and bright, ears clean and no erythema, Nose clean and wet. Dental score 1 with mild tartar at gingival line for 104/204. No halitosis or bleeding. Overbite prominent. 
ABDO: Comfortable with abdominal palpations, WNL
MSK: No pain responses to spinal or limb palpation, sits and stands with ease. Good muscle condition. 
UroGen: Not performed, he self-expressed anal glands during vaccination as has a nervous demeanor. 

Physical exam deemed ok to vaccinate
TREATMENT: Nobivac Bb/Pi B:2505001 EX:10/26 SC
Nobivac DHP B:2516201 EX:10/26 SC
FOL_UP: Next due in one year for Kennel cough.