Paseos Veterinary Center Patient Chart

Carr 199 Km 15.4 # 326 Cupey

San Juan, PR 00926
787-748-5228
Printed: 4/24/2014 at 11:42a
CLIENT INFORMATION
Name Mara Schiavetti Brand (3458)
Address Urb. Las Muesas; 102C/ Leonides Toledo
Cayey, PR 00736
Phone 561 573-9946
Email brand.maria@yahoo.com
PATIENT INFORMATION
Name Angel Andres (Record - 9428) Species Canine
Sex Male, Neutered Breed
Birthday 11/13/2008 Age 5y
ID Rabies 13-5210
Color Weight 42.00 lbs
Reminded (none) Codes
Reminders for: Angel Andres Last done
11/12/2014 Idexx 4DX HWM,ERL,ANA,LYM Test 11/12/2013
11/12/2014 DA2PL/PV Vacc 1yr 11/12/2013
11/12/2014 * FREE * Dental Checkup 11/12/2013
11/12/2014 Fecal Exam (Flotation) 11/12/2013
11/12/2014 Annual Wellness Exam 11/12/2013
11/12/2014 Rabies Vacc 1yr 11/12/2013
5/13/2014 Bordetella Vacc (INJ) 6mo 11/12/2013
Angel Andres's weight history (in lbs)
1/30/2014 42.00
12/17/2013 36.60
11/12/2013 37.30
MEDICAL HISTORY
Date By Code Description Qty (Variance) Photo
11/12/2013 SOAP Patient check-in 1
Age: 5y Weight: 37.30 Temp: 100.10
CRT: <2 secs. BCS: 3.00 / 5.00
SUBJECTIVE SECTION
Rescued
OBJECTIVE SECTION
A complete physical examination was performed on Angel Andres. Vital signs, hydration status and
color and refill time are noted above. Examination inspection, palpation and auscultation. Examination
included: the head, eyes, ears, nose, and oral cavity; lymph nodes; the thorax; the abdomen; and the
integumentary, reproductive, and musculoskeletal systems. The following abnormalities were
observed:
Paseos Veterinary Center
Carr 199 Km 15.4 # 326 Cupey
San Juan, PR 00926
787-748-5228
Patient Chart for Angel Andres Client: Mara Schiavetti Brand
Date: 4/24/2014, Time: 11:42a Page: 2
Date By Code Description Qty (Variance) Photo
Patient has severe generalized pyoderma with alopecia and chronic itching with skin thickening on the
caudal rump area. the patient also has bilateral ocular discharge patient also has a growth on ventral
abdomen SQ appears to be from the chronicity of the skin...
4dx + anaplasma + heartworm disease
Fecal -- hookworms
Heart and lungs are ok
Skin Scrape --- scabies +
ASSESSMENT SECTION
DIAGNOSES
HEARTWORM DISEASE
PYODERMA, DEEP
SARCOPTIC MANGE
11/12/2013 FOV VISIT Veterinary Consult 1
BIOFEE Bio Hazard Waste Fee Out Patient 1
IVOINJ Ivermectin 2% Inj. 0.15
DEXAMES Dexamethasone SP 4mg/ml Inj. 1
CONVENI Convenia Inj. 1.70
02357 Doxycycline Capsules/ Tablets 100mg 32
02108 Prednisone 20mg 6
RABIES Rabies Vacc 1yr, #13-5210 1
Items used: DEFEN03 Defensor 3-Rabies-Vaccine 1.00
ID: 13-5210 Serial: S301989C Expires: 9/sep/14 Type: KV Mfg: PFIZ Admin: SQ
11/12/2013 PPS STAMP CMVPR Stamp 1
11/12/2013 FOV DHLPP DA2PL/PV Vacc 1yr 1
Items used: VANGUAR Vanguard-DA2PL2/PV-Vaccine 1.00
ID: Serial: A303923 Expires: 21/10/14 Type: MLV Mfg: PFIZ Admin: SQ
BORDET Bordetella Vacc (INJ) 6mo 1
Items used: BRONCCA Bronchicine CAe Bordetella-Vaccine (INJ) 1.00
ID: Serial: A291679A Expires: 09-30-15 Type: MLV Mfg: PFIZ Admin: SQ
4220 Fecal Exam (Flotation) 1
HW4DX Idexx 4DX HWM,ERL,ANA,LYM Test 1
Items used: IDEXX4X Idexx 4DX HWM,ERL,ANA,LYM Test 1.00
DENCHK * FREE * Dental Checkup 1
1070 Boarding - Canine 21-40lbs 2
BPO3 BPO-3 Shampoo 16oz 1
SCMAT Science Diet Mature Orig Dry (17.5lbs) 1
8512 Bath - Nails + Ears - Canine 21- 50lbs 1
11/15/2013 FOV FAMOTAB Famotidine Tablets 20mg 10
11/22/2013 FOV 1070 Boarding - Canine 21-40lbs 12
8512 Bath - Nails + Ears - Canine 21- 50lbs 4
Paseos Veterinary Center
Carr 199 Km 15.4 # 326 Cupey
San Juan, PR 00926
787-748-5228
Patient Chart for Angel Andres Client: Mara Schiavetti Brand
Date: 4/24/2014, Time: 11:42a Page: 3
Date By Code Description Qty (Variance) Photo
11/26/2013 FOV CONVENI Convenia Inj. 1.70
11/29/2013 RGV 1070 Boarding - Canine 21-40lbs 12/13/13 16
12/7/2013 RGV PRAZQ Droncit 56.8mg/ml Inj. 1.40
12/17/2013 SOAP Patient check-in 1
Age: 5y Weight: 36.60 Temp: 100.00
BCS: 3.00 / 5.00
OBJECTIVE SECTION
Patient has recovered well from scabies and parasite infestation will give first dose of immiticide 1.7ml
deep epaxial right side
recheck in 30 days for second injection
The hair has been growing almost to its fullest ...... BAR eating and drinking ok rest of PE WNL
BODY SYSTEMS
Normal Systems: General Appear, Eyes, Ears, Oral-Teeth, Coat-Skin, Cardiovascular, Respiratory,
Gastro-Abdomen, Urogenital, Neurological, Musculoskeletal, Lymphatics
ASSESSMENT SECTION
NOTES
satisfactory progress continue with hw protocol
12/17/2013 FOV BIOFEE2 Bio Hazard Waste Fee Hospitalization 1
02357 Doxycycline Capsules/ Tablets 100mg 21
IMMITICI Immiticide Injection 2ml 1
FAMOTIDI Famotidine 200mg/20ml Inj. 1.70
CONVENI Convenia Inj. 1.60
DEXAMET Dexamethasone 2mg/ml Inj. 3
2150 Catheterization IV & 1st Liter Fluids 1
Items used: LRSFLUID IV Fluids Lactated Ringer Sol (1,000ml) 1.00
VETINFU CRI Pump Fee 1
1/7/2014 MTB 1070 Boarding - Canine 21-40lbs 01/07 26
1/15/2014 FOV 1070 Boarding - Canine 21-40lbs01/24/14 17
IMMITICI Immiticide Injection 2ml 1
DEXAMES Dexamethasone SP 4mg/ml Inj. 2.50
1/23/2014 FOV RCMADUL RC K-9 Maxi Adult Dry (35lbs) 1
1/28/2014 FOV 1070 Boarding - Canine 21-40lbs01/29/14 5
Paseos Veterinary Center
Carr 199 Km 15.4 # 326 Cupey
San Juan, PR 00926
787-748-5228
Patient Chart for Angel Andres Client: Mara Schiavetti Brand
Date: 4/24/2014, Time: 11:42a Page: 4
Date By Code Description Qty (Variance) Photo
1/29/2014 FOV 5140 Pre-Anesthetic Medication 1
11070 Pre- Surgical Fluids 1
Items used: BAJANT10 IV Line / Set 10 drops/ml 1.00
VETINFU CRI Pump Fee 1
3151 Castration - Canine 21-50lbs 1
SXMATERI Surgical Materials 1
Items used: SUTPDS20Suture Webmax PDS 2/0 1.00
SUTPDS0 Suture Webmax PDS 0 1.00
5075 Anesthesia (Iso, Masking & ET Intub) 1
1/30/2014 FOV 4100 CBC (Complete Blood Count) 1
Test Result Flag Normal Range Measure
Low High
AbaxisHMVTest 1/30/2014 10:23a
WBC 12.34 6.00 17.00 10^9/l
LYM 1.40 1.00 4.80 10^9/l
MON 0.40 0.20 1.50 10^9/l
NEU 8.81 3.00 12.00 10^9/l
EOS 1.55 0.00 0.80 10^9/l H
BAS 0.19 0.00 0.40 10^9/l
LY% 11.3 12.0 30.0 % L
MO% 3.3 2.0 4.0 %
NE% 71.4 62.0 87.0 %
EO% 12.5 0.0 8.0 % H
BA% 1.5 0.0 2.0 %
RBC 7.84 5.50 8.50 10^12/l
HGB 15.3 12.0 18.0 g/dl
HCT 49.38 37.00 55.00 %
MCV 63 60 77 fl
MCH 19.5 19.5 24.5 pg
MCHC 30.9 31.0 34.0 g/dl L
RDWc 16.1 0.0 0.0 % H
PLT 499 200 500 10^9/l
PCT 0.53 0.00 0.00 % H
MPV 10.5 3.9 11.1 fl
PDWc 38.8 0.0 0.0 % H
SOAP Patient check-in 1
Age: 5y Weight: 42.00 Pulse: 160.00
CRT: 2 secs. BCS: 3.00 / 5.00
SUBJECTIVE SECTION
Castracion
OBJECTIVE SECTION
A complete physical examination was performed on Angel Andres. Vital signs, hydration status and
Paseos Veterinary Center
Carr 199 Km 15.4 # 326 Cupey
San Juan, PR 00926
787-748-5228
Patient Chart for Angel Andres Client: Mara Schiavetti Brand
Date: 4/24/2014, Time: 11:42a Page: 5
Date By Code Description Qty (Variance) Photo
color and refill time are noted above. Examination inspection, palpation and auscultation. Examination
included: the head, eyes, ears, nose, and oral cavity; lymph nodes; the thorax; the abdomen; and the
integumentary, reproductive, and musculoskeletal systems. The following abnormalities were
observed:
BODY SYSTEMS
Coat-Skin
skin is significantly improved since initial presentation but there is still significant thickening of skin and
hyperpigmentation.
Normal Systems: General Appear, Eyes, Ears, Oral-Teeth, Cardiovascular, Respiratory, Gastro-Abdomen,
Urogenital, Neurological, Musculoskeletal, Lymphatics
1/30/2014 MTB NOTE Add'l Medical Note... 1
2/3/2014 FOV 1070 Boarding - Canine 21-40lbs 3/08/14 36
2/8/2014 FOV RCMAPP RC K-9 Maxi Puppy Dry (35lbs) 1
3/1/2014 FOV RCMAPP RC K-9 Maxi Puppy Dry (35lbs) 1
3/5/2014 FOV RCMADUL RC K-9 Maxi Adult Dry (35lbs) 1
3/24/2014 FOV RCPRAMI RC K-9 Pro Maxi Adult Dry (35lbs) 1
4/2/2014 FOV 1070 Boarding - Canine 21-40lbs 4/02/14 24
4/8/2014 SOAP Patient check-in 1
Age: 5y
4/8/2014 FOV RCMADUL RC K-9 Maxi Adult Dry (35lbs) 1
1070 Boarding - Canine 21-40lbs 4/08/14 6
4/21/2014 FOV 1070 Boarding - Canine 21-40lbs 4/21/14 13
4/24/2014 FOV RCMADUL RC K-9 Maxi Adult Dry (35lbs) 1