C10016658 / invoice 10000

WEIGHT: 22.6
SUBJECTIVE: Noticed lump under the tongue - has not grown bigger, noted it 2 weeks ago, initially hypersalivation but ok now 
No issues chewing food 
EDDU well, no v+ or coughing 
No itching 
Prev had rxn to bee sting - managed at ER 
No other concerns
OBJECTIVE: BAR 
DS: 1
MM pink CRT <2s
Eyes, ears, nose: NAD 
CVS: NAD 
Resp: NAD 
Abdo palp: NAD 
Salialoceoele
ASSESMENT: Given 3rd year KC vacc - next one due in 12 months

WEIGHT: 22.60
SUBJECTIVE: Will start whimpering and screams when he sits or moves on and off. Doesnt happen everytime but been occurring now and then for the last few months. 
O also noticed for the last few weeks a brown dot on the bridge of his nose that comes and goes with sometimes swelling in the area.
EDDU well
No other health concerns
OBJECTIVE: BAR, cheeky
MM- pink
Ds- gr 0
CV- NAD
Resp- NAD
Abdo- soft and comfortable
Ears- NAD
Eyes- NAD
Integument- brown debris from two follicles on the nose, no swelling or purulent discharge
MSK- resistance to ROM in hips otherwise NAD. No pain elicited on ROM or palpation
ASSESMENT: whimpering- ddx: hip dysplasia vs behavioural vs other
acne on nose
PLAN: Advised for blocked follicles on nose to monitor with revisit if swelling or hair loss occurs.
For whimpering we can either do sedated xrays now to exclude possibilities or monitor with xrays if worsening.
O happy to monitor whimpering episodes for now

WEIGHT: 21.20
SUBJECTIVE: Doing well
No concerns 
EDDU well, no v+ or coughing 
Parasite: UTD
Diet: kibbles + table scraps
OBJECTIVE: BAR, very sweet boy 
DS: 1
MM pink CRT <2s
Eyes, ears, nose: NAD 
CVS: NAD
Resp: NAD 
Abdo palp: NAD 
LN: NAD
ASSESMENT: Fit for 2nd year KC vacc
PLAN: Given 2nd year KC vacc - next one due in 12 months