C10011499 / invoice 10000

Appointment Notes: had a fight with Bravo at kennels, nwHistory:Has been at the kennels. Lost 6 kg since the last visit. All she does is run and bark, doesn't stay still. In kennels 4 weeks. Picked her up yesterday. Before she went in, Bravo has changed and there's been fighting. Both have scars all over them. Yesterday salivary gland was all swollen up yesterday. A little bit better today than it was yesterday. Has wounds on her face. Think salivary gland has only come up yesterday. Was noticeably puffed up, drooling off the left side. EDDU WNL, no v/d. Current medications: none Other concerns: Objective:GEN: BAR, very compliant, sweet, willing to be examined. EENT: No ocular or nasal discharge; clear eyes; ears clean of debrisORAL: Lower right lip edematous midway between lip commissure and rostral mouth, no dental wounds noted, no wounds along gums or gingiva, no wounds on mucous membranes on inside of cheek. MM pink and moist, CRT <2s; mild dental calculus/ gingivitisINTEG: Small 3 mm abrasion with scab beneath left eye. < 1 mm scabbed abrasion at right lip commissure, with hair loss and mild erythema along lip margin extending rostrally.Mild alopecia at xyphoid process, minimal erythema. No erythema ventral abdomen, medial thighs, axillary regions.  No evidence of ectoparasitesMS: Ambulatory x4, no pain on long bone palpation. UG: Externally normal; clean perineum.ABD: Palpates soft and nonpainful, no organomegaly or masses palpatedRESP: Eupneic; normal bronchovesicular sounds; no crackles/wheezes ausculted.CV: No murmurs or arrhythmias ausculted; femoral pulses strong, synchronous, and symmetricalLN: All external lymph nodes palpate soft, symmetrical, and of appropriate size.NEURO: Menace and palpebral reflexes intact; appropriate mentation.Assessment: Edematous lower right lip, suspect secondary to trauma. Inflammation vs salivary gland/duct disruptionSuperficial abrasions on skinSuspect allergic skin diseasePlan:Discussed salivary gland vs inflammation. Unlikely to cause long-term issues if it has already reduced since yesterday Avoid chew toys until back to normal. Start meloxicam 30 kg dose PO SID x 5 days (will use Bravo's bottle). Revisit if not improved. Discussed allergies-- recommend trialing atopy meds if persistent pruritus.     Vital Signs    Weight: 30;       MMColour: Pink;       HeartRate: 92;       RespirationRate: 28;       BodyScore: 4;       CRT: Less than 1;