C10016094 / invoice 10000

11/03/2026 NURSE: AM

REASON: Inappetence, swollen face

HISTORY:
- Ox noticed what looks like 2 large oral ulcers.
- Ocular discharge noticed this AM.
- Didn't eat dinner last night. Didn't eat much of dinner the night before either.
- Did a few years ago did have a ventral neck swelling.
- Does get allergies. No excessive scratching of face or eyes.
- No V+ or D+.
- Did urinate on son's bed the other day (4 days ago - unusual for him.
- Everywhere else on body seems OK.
- Hypersalivation.
- Not on any medications.
- Did sneak off the other day on block - but doesn't go far.

APPETITE: Reduced - didn't eat dinner last night or night before. Ate this morning but not as normal.
ACTIVITY: Bit slow this morning.
TOILETING: Normal poos. Unusual urination on son's bed 4/7 ago.
CURRENT MEDICATIONS: Nil.

CLINICIAL EXAM:
- Mentation: Not assessed
- MM: Pink, moist
- CRT: <1 sec
- Oral and Dental Score: Oral growths on gums - overgrowth of gums. No ulcers on R side. Some mild ulceration on L upper arcade.
- Eyes: Significant mucoid discharge from eyes bilaterally. Sclera injected bilaterally.
- Ears: No obvious discharge.
- BCS: 3/5
- Lumps: Not assessed
- Abdominal: Comfortable. Small comfortable bladder. No stool in colon.
- Lymph nodes: R submandibular LN slightly enlarged. L WNL. Prescapular LN WNL bilaterally.
- HR: 124bpm, normal sounds and rhythms
- RR: Clear chest sounds.
- Temp: 38.8°C
- Urogenital: Not assessed
- MSK: Not assessed
- Skin: No hives. Significant swelling - R side slightly worse than L.

ASSESSMENT:
- Suspect allergic reaction - suspect insect bite.

DISCUSSION:
- Boxers prone to allergic reactions.
- Common for inquisitive dogs to stick noses where they shouldn't.
- Previous wasp sting caused facial swelling - was itchy.
- This presentation not as itchy as expected but otherwise typical for allergic reaction.
- Facial involvement only suggests something contacted face directly.
- Oral growths are typical boxer gum overgrowth - benign but cover teeth completely causing food trapping and dental disease. Would need GA to remove and assess teeth underneath.

TREATMENT:
- Niramine 1.5ml SQ
- Dex 5mg/ml 1.2ml SQ

PLAN:
- Monitor closely over next 48hr.
- RV asap if INI.
- Swelling should resolve.
- Continue to improve expected.
- If not as expected - RV for further investigation.