C10015847 / invoice 10000

	
Dr Antonia Robbins
History: Owner reports ongoing history of passing smaller harder faeces than normal for a dog of his size. Owner reports sometimes looks like he is taking longer to pass faeces than normal. Sometimes stools are normal size, but more often small recently. Otherwise well, eating and drinking normally. Walks well every day.
Prime 100 diet, not for a medical reason.

Physical Examination:
Mentation: BAR
EENO: NAD
LNs: NAD
CVS: NAD, no murmur or arrhythmia
Resp: NAD, normal rate, rhythm and effort.
Abdo/GI: Soft and relaxed despite nervous nature, no abnormal structures palpated, no pain on palpation. NAD on digital rectal exam, rectum empty, no blood on glove, no abnormal structures palpated, could not palpate prostate as likely too far cranial.
Integ: NAD
MSK: Not fully examined, no lameness seen
Neuro: Not fully examined, no obvious deficits.

Problem List:

Passing small firm faeces.
A: NAD on examination.
DDx: Subclinical dehydration, low fibre diet, vs partial obstruction (nothing noticeable on exam)
P: Owner has just started adding pumpkin to diet, advised can continue this. Advised all wormer Tx, try to encourage water intake, continue pumpkin, a few tbsp daily. Monitor.
Re-ex if any change to appetite, any blood on stool, any V+, or if straining unproductively. Due vacc next month, if no increased concerns, recheck at vacc and consider adding fibre supplement if more support needed. If increasing fibre does not help, or if any increased concerns, consider further work up.