C10030913 / invoice 10000

Reason: Cough Concern. AGS As WellAppointment Notes: Special payment terms exist, Overdue remindersReason:Subjective and History:Coughing for months, slowly getting worse/more frequentHappens when she wakes upObjective: No heart murmurTrimmed back nails, would not allow front nailsExpressed anal sacs- fullCoughig/hacking heard. Lungs ausultate ok.Assessment: Coughing - possibe CCB, airway collapse, neoplasia, other infection etcO not keen on investigationTreatment: Doxycycline 50mg bid 3 weeksINB consider rads, or further treatment trial.    Vital Signs    

Reason: Were Given Antibiotics Yesterday, But Can't Get ThAppointment Notes: down Milli's throat - any alternatives?Only alternative ab is convenia- can give today, otherwise chlorhex SID1.26ml convenia given sc by mh. Good for injection in tx room, ate treats after with O. MH    Vital Signs    

Reason: Woke Up With Lump On Face Which Is BleedingAppointment Notes: MD - On her way at 8am but may be lateHx: brought in by a lady who is not the owner? She is not going to be with Millie today. This am was outside and suddenly pawing at face and itchy. Ulcerated circular lesion right muzzle. PE: BAR, euhydrated, BCS 3.5/5. Limited exam. Taken out back away from lady. 2cm raised ulcerated plaque that is mildly bleeding with mild right muzzle swelling. No petechiae/ bruising elsewhere. Abdomen very tense. HR 160. Panting. RE 0/3. CYtology: impression smear right muzzle- neuts, scant RBCSFNA right plaque- RBCS, neuts, scant eosinophils. Assessment: ulcerated skin lesion on right muzzle- insect bite reaction, contact allergy, food allergy. Tx: dex 0.5mg/kg pred equivalent 0.18mls IMNiramine 1mls SQWrapped in towel to injectPlan: amoxyclav 250mg BID May need ecollar. INB revisit - may need longer course pred?    Vital Signs