C10013989 / invoice 10000

Reason: Arthropen And General Qol Check TsAppointment Notes: Special payment terms existHistory: Has oral spindle cell mass and probable sternal mass and OAHe had a bad night last night, Richard thinks painful, maybe his mouth as he rubs itHas meloxicam which helps but is using it sparinglyExamine: BAR, nice dog however I did not visualise the oral mass as he bared his teeth/grinned and gave a low rumbly warning, probably would be ok to go further with exam, but I quite like my fingersHe is  very itchy and has alopecia where he chronically licks down paws, when he rolled over, ventrally is bald and inflamed and very strong itch/scratch reflex. Richard doesn't seem bothered by his licking and scratching. He used to use apoquel and can certainly have more but declined today, said it's too expensive. Can do a scriptReally struggles to rise on the slippey floor. Legs splay laterally but once he's up he moves around ok. His sternum is an odd shape, almost a reverse flail chestPlan: Arthropen and additional analgesiaTreatment: 1.5ml sc pentosan300-600mg gabapentin sid-bid depending on need/responseMeloxicam daily to 45kg mark (4.5mg) - could have 0.5 x 7.5mg mobic tab if funds need - better he gets analgesia    Vital Signs    Weight: 45;