C10031755 / invoice 10000

Reason: V+ Appointment Notes: Special payment terms existHistory: Presented for coughing/ retching and not wanting to eat. Brought up some of the chicken treat that he had last night. Has many issues already. Husband gave pred (12.5mg) tablet 2 nights in a row. Otherwise not on meds. Bloods with reg vet last week- WNL. Has neuropathy- knuckling in HLs with generalised weight-loss and issue with oesophagus been raised by reg vet. Had echo 7 years ago. Is on soft food. Didn't want to drink water this am either. Not unusual for him to go off food and water. Is flat for him- can also be normal. O other dog was PTS 2 weeks ago.Examination: BAR- but older dogHR: 100 with arrhythmia, no obvious murmur, SSFP. RR: intermittent cough. A little sensitive for mild palpation along both trachea region and abdo- gets a light cough. Mouth: 2/4 dental, has mild hypersalivation. MM: pink and moist, CRT: <2sec. Abdo: lean and no obvious palpation. LN: WNL. Neuro: no facial deficits, has knuckling of HLs. Generalised muscle loss. T: 37.5. Eyes: blue opacity, no signs of discomfort. Integument: has many lumps- no new ones and all been tested. Ears mildly dirty externally. Laboratory: - NilAssessment: Problem list:- Cough- Arrythmia- Inappetance- Neuropathy- Issue with oesophagus. - LethargicTreatment: - Home with ondansetron. Consent has been given by the client to proceed with this treatment  -  YesPlan:- Discussed Sucralfate for O. Ondansetron to see if nausea as goes to bowl and shows interest and then doesn't eat. - Discussed arrhythmia- halter ideal and ECG. - Rads if coughing not resolved (O reports always has mild cough and is 70% better but wanted to bring in anyway).    Vital Signs    

Is doctorAsked for prescription neocort from nurse with no appointmentExplained pharmacy lawsRefused malaseb and e collar Communincation barrier?Booked for monday skin ears eyesHAS 3 FILES with animals    Vital Signs    

Hills Dog Biome    Vital Signs