C10017188 / invoice 10000

WEIGHT: 7.80
HISTORY: RFV:

Coughing recently 
Yearly checkup hasn't seen us before, moved from Concord recently
Had parvo as a puppy, went to SASH. Hand reared. 

Coughing every so often, coughs once a day. 
Dry, cough once or twice

ENTIRE - O concerned about anaesthesia risk
   
Energy: More lethargic recently
Appetite: Normal, fussy
Diet: Ziwi and blackhawk kibble, mince, marrow bones
Drinking: Normal
Urination: Normal
Defecation: Normal
Vomiting: 1x bile vomit last week. 
Cough/Sneeze: None
Mobility: 1 bag leg seen by SASH orthopaedic already. 
Other Pets: None
Vaccs: 
FTW: NGS monthly
Other: 

Diagnosed Conditions: Parvo as a baby, 
Current Medication:

EXAM
BCS
Mentation:
Ears/eyes/nose: Clear, no discharge bilaterally.
Mouth: NAD, Dental grade /4.
LNs: WNLs
Cardiovascular: HR 180, possible grade 1-2 HM, SSFPs, MMs p+m, CRT < 2
Respiratory: Chest auscultation NAD, RR pant
Abdominal: NAD, soft and comfortable
Urogenital: NAD, no significant findings
MSK: NAD, not fully examined
Neuro: Not fully examined
Integ:
Temp: Not taken

DIAGNOSTICS
SpO2 100%
Tracheal pinch negative

PROBLEM LIST
- coughing daily
- Possibel heart mumrur
- lethargy

ASSESSMENT
Possible heart vs prmary respiratory disease. Has had for >12 months now so less likely to be infectious. 
Has been getting progresively worse
Os are insured and would like to rule out heart dx as prev. dogs have had it. 
Recc can do echo as first step with bloods, then consider chest rads if clear.
Quoted 1300 daron rads
quatoed 900-1100 for chest rads
Recc'd bloods as well

TREATMENT
Gabapentin and trazadone for pre-vet anxiolysis prior to echo. 

PLAN
Book for echo at next available
To send information about MMVD and RRR
WRMRQ: N
FLRQ: N