C10021013 / invoice 10000

REASON- D+ and coughing

HISTORY-
BAR, edu normal, had D+ for a few days but had changed diet at the time, not sure if related. Also started coughing last day or so since going to doggy day care + PPS. Only a small retch, not very often, but wanted to get it checked. 
Diet: puppy dry food
F/T/W/HW: UTD
Medications: none

EXAM-
Demeanour: BAR
BCS  3/5
HR:  120bpm
RR:   pant
T:    38.6
CRT: 1sec    
MM: pink & moist
CHEST: NAD
EYES: NAD
EARS: NAD
NOSE: NAD
ORAL EXAM: NAD  
SKIN:  NAD
ABDOMINAL PALPATION: soft, non painful
MUSCULOSKELETAL SYSTEM: NAD
Small dag on bottom

ASSESSMENT:
Suspect mild KC
D+ due to diet change

Tx:
None

PLAN:
Can get linctol if getting worse, prokolin if D+ reoccurring. Keep away from other dogs until coughing stops. 

REASON- Vaccination

HISTORY-
BAR, eddu normal, no vcds
Diet: unchanged
F/T/W/HW: ng spectra due monday
Medications: none
Lost his first tooth

EXAM-
Demeanour: BAR
BCS  3/5
TPR – HR:  RR:  T: NE  
Chest: NAD
Eyes: NAD
Ears: NAD
Nose: NAD
Oral exam:    0/4 Dental dz, MM P&M CRT <1s
Integument:  NAD
Abdo palpation:  NAD
MSK exam:  NAD

ASSESSMENT:
Healthy, fit for vaccination

Tx:
Nobivac DHPPi  + lepto 2 SC dorsal midline - jumped for needle needed distraction
Nobivac BB oral PO

PLAN:
Booster due 12mths, can go out in 10d

REASON- Vaccination 2nd puppy

HISTORY-
BAR, eddu normal, no vcds. no health concerns
Diet:
F/T/W/HW: ng spectra at home
Medications: none

EXAM-
Demeanour: BAR
BCS 3 /5
TPR – HR:  RR:  T: NE  
Chest: NAD
Eyes: NAD
Ears: NAD
Nose: NAD
Oral exam:    0/4 Dental dz, MM P&M CRT <1s
Integument:  NAD
Abdo palpation:  NAD
MSK exam:  NAD
2 desc testicles, no hernia, no hind dew claws

ASSESSMENT:
Healthy, fit for vaccination

Tx:
Nobivac DHPPi + lepto 2 SC dorsal midline
Nobivac BB oral PO

PLAN:
Booster due 1mth final booster
talked through puppy handout