C10024542 / invoice 10000

Reason: Vaccination + Bad BreathAppointment Notes: gbHistory:D+ ongoing for several weeks. Has now become fluctuant between diarrhoea and formed stools. Accompanied by halitosis and grass eating Energy - a bit off for since the diarrhoea started Appetite good Possible dietary indiscretion --> scavenges Nexgard spectra monthlyMedications: none Examine:Bar Eyes ear clear Oral membranres pink and moist crt <2sDental disease gr 3 pt requires dental Lns wnlsHeart and lungs nad Abdomen nad T 38.6 Perianal area clear Skin nad Plan:Durammune C4 sc Bb orally Dental required and then pt will require elevated oral hygiene afterwards as has dentals regularlyRe D+ suspect GIT  biome imbalance post insultProkolin to start Then ini blood tests +/- faecal analysis (offered today but owner would like to try probiotics first )    Vital Signs    Weight: 30.8;       

Reason: Promo DentalAppointment Notes: gbO declined bloods PreGA check OK Anaesthesia: 0.9ml methadone + 0.3ml ACP SC IV Alfaxan via 22G catheter R cephalic v Iso/O2 via 10mm ET tube IV fluids 5ml/kg/hr GA stable Routine S&P. Mild diffuse tartar. No extractions required Plan: Discussed tartar control eg brushing teeth No recheck required    Vital Signs    Weight: 30.5;       

Reason: Check Lump On SnoutAppointment Notes: gbHistory: O has her on a diet and is booked n for dental on Monday. O found a small growth on LHs of muzzle today (her daughter said a whisker fell out from that side of her muzzle a day or two ago.Examine: small lesion raised from the skin approx 2mm diam - folliculitis? Vs emerging BCH vs tiny adenoma that has been traumatised?Chest/heart ausc NADAbdo palp NADLNs NADOverweight.Ears bilat waxy and slightly sore when swabbedLaboratory: ears bilat Malassezia +/++Assessment: growth likely something benign vs just a folliculitisOETreatment: dermotic bilat BID x 7d.O has neocort at home adv apply 2-3 times daily. Can recheck it when having dental on monday. Could remove if really worrying the client at that stage. Plan: as above. Carry on with diet.    Vital Signs    Weight: 31;       MMColour: pink;       HeartRate: 104;       BodyScore: 6.5;       DentalGrade: 1;       RespirationRate: panting;       CRT: < 1 sec;