C10021034 / invoice 10000

Reason: Check EyesAppointment Notes: Overdue remindersPATIENT:Chloe2 yearsFemaleWeight: 20.3 kgReason: Bilateral eye puffiness and dischargeHistory:Chloe is a 2 year old Border Collie presented today for bilateral eye puffiness and discharge. The owner reports puffiness under both eyelids for approximately 3 days. This morning there was thick discharge in the eye which was cleaned with warm water. No rubbing or scratching noted. No licking of paws. No scratching of sides. Recently had a dog from the same kennel stay last week which arrived with conjunctivitis.Current medications: NexGard Spectra monthlyExamination:Vitals:    - Weight: 20.3 kgPhysical Exam:    - General Appearance: Plump    - EENT: Right eye - discharge present, inflamed. Left eye - inflamed. No scleral injection. Eyes otherwise appear normal.    - Oral Cavity: Teeth reasonably good, small amount of tartar, no gingivitis    - Integument: Wet from pool    - Abdomen/GI: Abdomen feels good    - Musculoskeletal: Legs feel goodASSESSMENT:Conjunctivitis, bilateralPLAN:Diagnostic/Treatment Plan: Topical eye cream twice daily. Wash eyes first before applying cream. Apply cream on finger then to eye for better control. Should clear in 4-5 days.Recommendations: If not clearing, consider allergic component and will provide additional medication to address allergy. Contact clinic if any problems.    Vital Signs    Weight: 20.3;       

Reason: Call To C/uAppointment Notes: Overdue remindersCTDoing much betterDefecating normallyStill isnt feeding any raw meat as the O wants to play it safeO says she still seems a bit tired but could possibly be just her personality. Will call if she notices anything    Vital Signs    

Reason: D+ Off And On For A Few Weeks - Wants Sf Appointment Notes: Overdue remindersPATIENT:Chloe1 year 9 months, DOB:Female, SpayedWeight: 19.75 kgReason: Intermittent diarrhoea.History:Chloe is a 1 year 9 month old Border Collie who was presented today for recheck to monitor intermittent diarrhoea. The owner reports this has been occurring on and off for a few weeks. Stool consistency varies from normal to sloppy. Reports lethargy during walks when diarrhoea is present, wanting to stop and lie down. Otherwise, behaviour is normal, including activity levels, appetite, and water intake. Diet was Supercoat, but for the past week has been chicken and rice with pumpkin. A history of diarrhoea was noted after being fed raw chicken necks, which have since been ceased for a month, but the intermittent diarrhoea persists. Increased flatus has been noted recently. A single episode of bile vomiting was reported by the owner's husband yesterday after a walk, but has not been observed by the primary owner.Current medications: Nil.Examination:Vitals:    - Weight: 19.75 kgPhysical Exam:    - General Appearance: Bright, alert, and responsive. Good body condition. Appears nervous and is shaking during the consultation.ASSESSMENT:Intermittent diarrhoea, suspect dysbiosis secondary to potential bacterial gastroenteritis from previous raw chicken consumption. Concerned about potential for developing irritable bowel disease if inflammation persists. Protein-losing enteropathy is less likely given good body condition and normal activity levels.PLAN:Diagnostic/Treatment Plan:    - Metronidazole to address potential bacterial overgrowth.    - Enterogenic powder to support gut flora, one sachet sprinkled on food twice daily.    - Cease Metamucil for now.Recommendations:    - Continue with a diet of chicken and rice with some biscuits.    - Avoid all raw chicken.    - Advised that Pro-Kolin is available over the counter for future use if needed for acute episodes, but Metronidazole is indicated now due to the chronic nature of the signs.    - Monitor for improvement. If signs persist or worsen, further investigation will be required. Advised against starting steroids at this stage.    - May consider adding a small amount of original flavour Metamucil in the future to add bulking fibre if stool remains poorly formed after the current treatment course.    Vital Signs    Weight: 19.75;