C10025841 / invoice 10000

Reason: Recheck And Weight CheckHistory-Update:History:- Recheck visit for weight management and medication review for polyarthritis.- C/O dysappetite but no significant weight loss.- History of finishing own food and eating other dogs' food.- No other treats given.- On recommended tummy dose of food.- No V+/D+.- EDUF normal.- Swims for exercise, no running.- History of immune-mediated polyarthritis (IMPA), diagnosed previously.- Previously on steroids, now on anti-inflammatories.Examination:- Mentation: Bright, alert, and responsive.- BCS: 6.5/9- Hydration status: Mucous membranes pink and moist, capillary refill time <2 seconds.- CVS: HR 80 not taken. No murmurs or arrhythmias auscultated. Pulses strong and synchronous.- Resp: RR not taken. Lungs clear on auscultation bilaterally, no abnormal respiratory sounds.- EENO: Left ear appears slightly dirty. Right ear NAD. No ocular or nasal discharge noted. Grade 1-2 dental, no oral pain.- PLNs: Peripheral lymph nodes are normal in size and texture.- MSK: Ambulatory. Left hip slightly stiffer than right hip. Slight reduction in ROM bilaterally- Abdominal: Abdomen is soft and non-painful on palpation.- Integument: Skin and coat are in good condition.- Rectal: Not performed.- Neuro: neurological examination is grossly normal, no deficits noted.- Urogenital: Normal.Problem list:- Weight management (overweight)- Immune-mediated polyarthritis (IMPA)- Mild otitis externa (left ear)Diagnostic tests:- Weight check: 30.6 kg (previously 31.5 kg one month ago). Weight loss of 0.9 kg.Treatment:- Dispensed Carprofen 100mg tablets x 100. To be given 50mg twice daily (~3.3/mg/day)Plan:- Reduce current food amount by 10.- Can bulk food with low-calorie options (e.g., carrots, sweet potato, pumpkin).- Use ear flush after swimming.- O requested monthly weight checks at clinic.- Re-assess in 2-3 months.- Blood test due November.Client Communication:- Discussed weight loss progress. It's slightly slower than the 1% per week target but good progress- Advised on food reduction and bulking options.- Discussed the importance of controlled exercise like swimming for her joints.- Advised to use ear flush after swimming to prevent ear issues.- Discussed medication dispensing options for cost-effectiveness.- O to bring Tully in for monthly weight checks, which will be updated on her file.    Vital Signs    Weight: 30.6;