C10023365 / invoice 10000

Reason: Pregnancy UltrasoundAppointment Notes: Special payment terms existWas brought in to be speyed but was sent home due to skin issues. Was never meant to have a heat.Went away first 2 weeks of Jan and had a house sitter looking after them. Roxy went into heat around this time. Mammary gland enlargement occurred during this heat and has gotten even bigger since.O thinks fencing around house is good and doubts dogs could get in but still worried due to prolonged sleeping mammary gland enlargement.O has been palpating teats every other day checking for changes.History:Current issues - Enlarged mammary glands - preg? Phantom preg? Current medications - Cytopoint in the past. Neocort for skin flares. Medicated shampoo three times a weekPrevious health concerns - Itchy. Reacts to grass.  Has been on cytopoint but owner said previous one made it worseParasite prevention - Bravecto at home. SR12Vaccines - UTDEating and drinking - WellDefecation and urination - NormalExamine: Mentation - BARTeeth - No dental dxEyes - Clear. No discharges Ears - Mild debris. Nose - No dischargesHR - no obvious murmurs or arrhythmia, strong and synchronous femoral pulsesRR --clear bilateral lung soundsAbdo --comfortable, no obvious organomegally or massess palpatedLns - wnlInteg - Skin looking goodMSK - NADUrogenital - Mammary glands enlarged. Producing small amount of milk.Laboratory: Right and left ear cytology: 1-3 yeast per HPFAssessment: No pups seen on US. Most likely phantom pregnancy - EL and BB checked Very mild yeast growth in ears. Unconcerned.Allergic skin disease - looking good currently, cont TIW shampoo and conditioner. Cytopoint didn't work well in the past.Would be 6-7 weeks along if did get pregnancy when housesitter was looking after Roxy --> recc stop tactile stimulation of mammary glandsClient Communication: Discussed above - most likely phantom pregnancy, we would miss a very early pregnancy however. Plan:Keep spey appointment for 1monthIf still showing signs of phantom pregnancy then delay desexing recommendedMay need to look into prolactin suppressants?Instructed O not to palpate teats as tactile stimulation can lead to development of phantom pregnancy.    Vital Signs    Weight: 25.5;       MMColour: pink;       Temperature: 38.3;       HeartRate: 96;       CRT: <2;