C10019424 / invoice 10000

Appointment Notes: nipple check - are swollen, is on heat. pvh ?????History:Presented for assessment of swollen mammary glands, first noticed 1-2 weeks ago. The owner is concerned about a possible pregnancy. Blaze was in oestrus from approximately 02/02/2026 to 25/02/2026. The owner reports Blaze is bright, energetic, eating and drinking well, with normal stools. A recent episode of an upset stomach 1-2 weeks ago has resolved without treatment. No mammary discharge has been noted. The owner is diligent with on-leash management and avoids dog parks.- Significant history: Dental surgery on 11/02/2026 with three teeth extracted. Spay postponed due to dental procedure. Recent transient gastroenteritis, resolved.- Current medications: None.- Appetite & diet: Good appetite. Fed kibble and some chicken.Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperemia, no epiphora.- Ears: Ears clean, no malodour.- Oral: Recent dental surgery (11/02/2026), three teeth extracted.- Nose: NAD.- Cardiovascular: No murmurs or arrythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Normal coat, no ectoparasites.- Abdomen: Soft, no masses palpated. Moderate, symmetrical mammary gland enlargement, consistent with recent oestrus. No heat, pain or discharge noted.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Not assessedAssessment:Problem List:- Mammary gland enlargement post-oestrus (differential diagnoses: pseudopregnancy, pregnancy).- Entire female.Treatment:Plan:- Monitor at home. Recheck if mammary glands remain significantly enlarged at two months post-oestrus.- Recheck for abdominal palpation in 1-2 weeks (approx. 20-25/03/26) if pregnancy concern remains.- Pregnancy blood test offered as an option, to be performed at one month post-potential mating (end of March) for a reliable result.Client Communications:Discussed that mammary enlargement is a normal physiological change following oestrus in up to 50% of entire bitches (pseudopregnancy/phantom pregnancy) and can last for up to two months. Advised that pregnancy is considered unlikely given the history but cannot be definitively ruled out on examination today. Explained options for pregnancy diagnosis, including timing and limitations of palpation and blood testing. The cost of a blood test (approx. $300) was discussed. The option of medical termination was mentioned should pregnancy be confirmed, but advised it is not ideal due to cost and side effects. Owner to monitor and will return for diagnostics if suspicion of pregnancy increases.?????    Vital Signs    Weight: 15.5;