C10020770 / invoice 10000

05/03/2026 Consult nurse: TC

Reason for presentation: GHC + itchy

History for today:
3.5-month-old puppy. Disinterested in food, particularly at breakfast. Will walk away from bowl. Will eat small amounts if food is placed on the floor. Feeding in a quiet kitchen area. Has tried different bowls. Currently eating Royal Canin Maxi Puppy, 2-3 meals per day, approx. 250g per meal. Also given some fresh/cooked meat. Vomited on first two car trips, likely motion sickness. Itchy for two weeks, scratching tummy and legs, now resolved. Scratching ears noted. No other pets in the house. Has been sleepy today and less interested in water.

Previous medical/surgical concerns: Nil.

Current medications:
Excelpet wormer (praziquantel 50mg) - 2 tablets given on Monday.

Diet: Royal Canin Maxi Puppy, fresh/cooked meat.

Examination:
Demeanour: BAR
Eyes: Clear
Ears: Left ear slightly red. Wax present but not excessive. Right ear NAD.
Nose and Throat: No abnormalities detected
Mouth/teeth/gums/dental grade: Pink and moist, deciduous dentition normal.
Resp rate: sniffy, Lung fields clear
Heart rate: 148bpm, Regular, nil murmurs, pulses strong and synchronous
Abdominal palpation: Comfortable and relaxed
Urogenital: Normal conformation, no abnormalities detected
Musculoskeletal: Ambulating well but not thoroughly examined
BCS: Excellent weight and body condition 
Coat/skin: Healthy
Palpate lymph nodes: Within normal limits

Lab cytology ear swabs: NSF

Assessment:
 Poor appetite, likely behavioural/distraction related. 

Treatment:
NexGard Spectra chew given in clinic for flea, tick, and mite prevention.

Next vaccination due: Up to date.

Discussion:
Owner is feeding approximately 3 cups (750g) of dry food per day, which is significantly more than the recommended daily amount of 250-300g.
Advised to reduce portion sizes to recommended daily amount and feed in a quiet, confined space.
Continue with Royal Canin Maxi Puppy food. Limit fresh meat to 25% of diet.
Worming schedule: monthly until 6 months, then every 3 months. Ensure wormer contains praziquantel (e.g., Milpro, Milbemax, Drontal Plus).
Desexing: Plan for around 12 months of age, after first heat cycle. Recovery is approx. 2 weeks.
Nail care: Start handling paws now to get used to it. Nails are currently a good length.
Ear care: Can clean externally with a tissue. Be mindful of moisture in ears after swimming.

Plan:
Reduce food portions to recommended daily amount.
Feed in a quiet, confined space.
Monitor appetite and weight.
Continue monthly worming.
Start flea/tick/mite prevention (NexGard Spectra given today).
Plan for desexing around 12 months of age.
Start handling paws for nail care.

Next revisit: As needed if appetite does not improve.