C10029983 / invoice 10000

Check as is panting more, seems lethargic.Eating OK, mobility otherwise OK.Pants at rest, and is noisy panting.No cough (now that ITB has settled) or gag.Examination:BrightPanting constantly in exam  noisy but no stridor.Some residual tracheal sensitivitymm pink, moist.Ausc NAd - normal rate andrhtyhm, no murmur. Lung sounds clear - some reffered URT noise.Very large lipoma left flank.Lnn NADAbdominal palpation - concerned there may be mass effect v]cranially - but is difficult to palpate due to BCS.Normal CP reflexes all 4 legs.Not PU/PD, normal fur growthDiscuss with owner  Unlikely to be Cushings based on symptoms, and low normal ALP 8 months ago.Most likely to be LP - discuss surgery vs complicationsDDX other laryngeal disease, thoracic/pulmonary disease, pressure from mass in abdomen /organomegalyPrepare estimate for chest rads and AUS in house, plus laryngeal exam.Ideally would lose weight to ease demand on breathing    Vital Signs    MMColour: Pink;       HeadEyes: Normal;       Nose: Normal;       Skin: Normal;       MusculoSkeletal: Normal;       Ears: Normal;       Neck: Normal;       LymphNodes: Normal;       Heart: Normal;       Lungs: Normal;       Abdomen: Abnormal (Concern re mass effect in cranial abdomen);       RectalGenetalia: Normal;       Demeanour: BAR;       Calculus: 2;       HeartRate: 120;       BodyScore: 7;       DentalGrade: 2;       CRT: Less than 1;