C10018783 / invoice 10000

Reason: Recheck AsthmaAppointment Notes: Overdue remindersHISTORY:Carly presented for increased frequency of asthma attacks over the past week. Previously well-controlled on puffer medication BID (fluticasone propionate) for over a year with no attacks. Owner reports attacks occurring mostly after dinner, though some episodes have no obvious trigger. Owner has modified feeding to smaller portions which has helped reduce post-meal episodes.Non-specific History: Diet: no changesOwner tries to brush Carly's teeth, not well tolerated sometimes Current meds: Fluticasone propionate 125ug puffer BID Vaccination: F3 vaccination UTDParasite Prevention: Not mentionedPre-existing conditions: AsthmaAccess to toxins eg. Rodenticide: nonePHYSICAL EXAMINATION:Mentation - BAR**BCS: 7/9Eyes - NAD, both visual, corneas transparent, no blepharospasm or epiphoraEars - NAD, responds to auditory stimulus, ears free of discharge or odour** Oral - Mild gingivitis noted on molar teeth, some redness presentLNS - NAD, submandibular, prescapular and popliteal lymph nodes symmetrical, normal size and consistencySkin, nails and coat - NAD, no signs of ectoparasites or scales and crusts, seasonal shedding notedCirculatory - NAD, pulse strong & synchronous, no heart murmurs/arrhythmiasChest ausc - NAD, no wheezing or crackles, normal bronchovesicular sounds bilaterally. Not reactive with tracheal palpation. MSK - No lameness or ataxia appreciated. Full MSK exam not performedGait - NAD, appropriate mentation, full exam not performedNeural - NAD, full exam not performedAbdo palpation - NAD, soft on palpation, no masses or enlarged organs palpatedGenitourinary - No discharges from vulva. Desexed animal. Bladder moderate size and comfortable, kidney palpation is unremarkableASSESSMENT:Increased frequency of asthma attacks ddx: feline asthma exacerbation possibly triggered by seasonal allergens/ airway inflammation Mild periodontal diseaseOverweight (weight slightly increased from previous visit despite controlling diet) TREATMENT:Prednisolone 5mg tablets - ONE tablet ONCE daily for 5 days to reduce possible airway inflammationContinue current fluticasone propionate 125ug puffer BID PLAN:Monitor response to prednisolone treatment over 5 daysContact clinic if no improvement in attack frequency. Additional Ventrolin puffer bronchodilator (BID) script can be provided if neededMaintain dental hygiene with regular brushing 2-3 times weekly and dental treatsContinue weight management with reduced kibble portionsCLIENT COMMUNICATION:Owner advised that seasonal allergens may be contributing to current asthma exacerbation. Prednisolone medication explained to help reduce airway inflammation. Instructions given to administer medication in morning. Owner advised to contact clinic if no improvement seen within treatment period, and Ventrolin puffer script can be provided. Weight management discussed with target weight of 4.5kg. Dental care recommendations provided including regular brushing and dental treats.    Vital Signs    Weight: 4.88;