C10026060 / invoice 10000

Dog presented 6:55pm with sudden onset facial swelling. O has been at work all day and come home to find dog like this. Dog has eaten without issue and seems happy in himself. No v+.
Does have access to the outside, and does snap at flies (and bees!)

Dog is anxious and trying to hide but BAR. Facial swelling, esp R side ventral mandible and cheek.
MM pink, crt<2secs.  eyes and ears nad. Oral exam nad. No pain on opening mouth. No pain on palpation of swelling.
Abdo palpation nad. Chest sounds clear. HR 100bpm.
Temp 39.2.
Unable to find insect sting in mouth/lips/oral cavity/nose etc...

Suspect allergic reaction but unable to be 100% sure.
Suggest tx with niramine inj and PCEV if any concerns overnight.
O happy with this plan.

0.33ml niramine SC.

Will cc tomorrow.

Wellness Check

NURSE: 

HISTORY: 
EDUF all ok.  No v+/d+; no coughing.
Current medications: No
Current diet: Mix of dog food and quite a bit of cat food as he prefers it
 
CLINICAL EXAM: 
Demeanour:  BAR
BCS:  5/9   Weight assessment:
Temp: 37.4
HR: 148
No heart murmur detected
RR: 44
Chest sounds clear
MM: <2
CRT: PK

Coat: Good healthy
Skin: Good
Lumps: No
Eyes: Good
Ears: Good

Dental grade: 1 /4 
 
Other findings: He's quite nervous but really good
 
TREATMENT:
Parasite control: Bravecto Q yearly, worm tabs