C10031359 / invoice 10000

Appointment Reason: Vaccination, Appointment Notes: ?CG.  Chester (Dog) - Vaccination [Veterinarian : Cairns Vet Consults(No Preference)] - Vax -  - 0429826409 - -Angela - LiversageWeb BookingClient name: Angela LiversageContact number: 0429826409Email address: angelaliversage@live.com.auPatient name: ChesterSUMMARY* 4-year-old male Dachshund presented for annual vaccination. History of grass allergies managed with Apoquel, and being overweight.* Diagnosed as overweight with mild ceruminous otitis externa. Otherwise healthy.* Received DHP+Lepto and intranasal KC vaccines. Dispensed Apoquel. Plan includes weight management and a Leptospirosis booster in 4-6 weeks.HISTORY* History of atopic dermatitis (grass allergy), managed with Apoquel PRN and Malaseb shampoo during flare-ups.* Previous history of an anal gland abscess.* Owner reports a suspected adverse reaction to a recalled Leptospirosis vaccine several years ago.* Prevention: NexGard Spectra monthly for heartworm, fleas and ticks.* EDDU normal, no CSVD, BAR at home* O has no other concernsEXAMDemeanour: BAR; friendlyBody condition score: 7/9 (10.9 kg)Mucous membranes: moist, pink, CRT < 2secTeeth: grade 1/4 perioEyes: eyes clear, no signs of conjunctivitis, pupils symmetrical and normal sizeEars: Mild ceruminous discharge bilaterally.Head/nose/neck: Prominent occipital crest noted, WNL on palpation. No lesions or nasal discharge observed.Heart: heart rate is normal, regular rhythm, synchronous pulses, no murmur detectedLungs: respiratory rate and effort are normal, clear lung sounds all fields, no crackles/wheezes heardAbdomen: abdominal palpation normal, soft and non-painful, no obvious masses identifiedCoat & skin: no unusual masses noted, normal skin tent. Mild scabbing along lateral chest. Ambulation & MSK: normal ambulation in consult. Mild generalised discomfort on palpation. Lymph nodes: all palpable LNs are WNLASSESSMENT* Overweight.* Atopic dermatitis (grass allergy) – chronic, currently controlled.* Patient is fit for vaccination today.TREATMENTKC intranasalDHP inj SCLepto #1 inj SCPLAN* Leptospirosis booster vaccine required in 4-6 weeks.* Repeat KC/lepto annually, repeat DHP triennially* Continue NGS q1m and drontal q3m. * Continue apoquel 4mg PO SID as required for flareups. AN AUTH repeat apoquel <6m. * Reiterate weight management plan: reduce overall food quantity and limit treats.CLIENT COMMUNCIATION* Discussed restarting the Leptospirosis vaccine course due to being overdue, and the requirement for a booster in one month.* Advised on weight management strategies.* Client enquired about alternative injectable heartworm prevention options.??    Vital Signs    Weight: 10.9;