C10028696 / invoice 10000

Reason: C/uAppointment Notes: Special payment terms exist, Overdue remindersPATIENT:Dulce6 years, 2 monthsFemale, IntactWeight: 9.1 kgReason: Recheck to monitor mammary gland conditionHistory:Dulce is a 6 year, 2 month old female intact miniature dachshund presented today for recheck to monitor mammary gland condition. Owner reports finding maggots around bed and water bowl near patio. Owner checked Dulce thoroughly and found nothing abnormal. Dulce is eating but only meat and bone, reduced appetite overall. Still making retching/coughing sounds. Playing and behaving normally otherwise.Current medications: Convenia injection given 06/03/2026 (covers 2 weeks)Examination:Vitals:    - Temperature: No fever    - Weight: 9.1 kg (previously 8.9 kg)Physical Exam:    - General Appearance: Improved, eating, playing, normal behaviour    - Oral Cavity: Gums pink    - Integument: Skin previously poor, now much improved    - Urogenital: Mammary glands looking good, improvedASSESSMENT:Mammary gland condition improvedWeight gain notedNo feverMaggots found in environment likely from mango, not from DulcePLAN:Diagnostic/Treatment Plan:    - Betamox short acting injection given    - Maropitant injection given subcutaneously    - Ovariohysterectomy recommended - two estimates to be provided: one for normal uterus, one if pyometra found on opening    - If pyometra found or not 100% recovered post-surgery, may perform abdominal wash under anaesthesia with specific antibiotic    - Convenia still providing coverage until 20/03/2026Recommendations:    - Clean around living area to remove any mango that may have dropped    - Discuss pre-approval for insurance with Stephanie    - Consider injection for parasite prevention once recovered post-surgery    - Omar to monitor and discuss desexing with Stephanie    Vital Signs