Progress Review

#PROGRESS NOTE 01 November 2024 Introduction: [Patient Name], a 5-year-old Golden Retriever, is presented today with their owner, [Owner Name]. The dog lives in a suburban home with a fenced yard and is generally active and well-cared for. Patient’s History and Current Status: [Patient Name] has a history of mild seasonal allergies, managed with over-the-counter antihistamines. The dog is up-to-date on all vaccinations and is on a monthly heartworm preventative. There have been no recent changes in diet or exercise. The owner reports no significant changes in the dog's behaviour or appetite. Presentation in Clinic: [Patient Name] appeared bright, alert, and responsive during the examination. The dog was accompanied by [Owner Name], who was cooperative and provided a detailed history. The dog's coat was shiny, and the body condition score was ideal. The dog was friendly and allowed a full physical examination without issue. Mood and Mental State: The dog displayed a happy and relaxed demeanour throughout the visit. There were no signs of anxiety or distress. The dog was eager to interact and showed no signs of aggression. Social and Functional Status: [Patient Name] enjoys regular walks and playtime in the park. The dog interacts well with other dogs and people. The owner reports that the dog is well-behaved at home and follows commands. The dog is not currently enrolled in any specific training programs. Physical Health Issues: The dog's physical examination revealed no immediate concerns. The dog's weight is appropriate for its breed and age. The owner was advised to continue with regular dental care, including brushing the dog's teeth at home. The dog is under the care of a general practitioner for routine check-ups and vaccinations. Plan and Recommendations: 1. Continue with the current diet and exercise regimen. 2. Administer monthly heartworm preventative as prescribed. 3. Continue with regular dental care, including brushing the dog's teeth at home. 4. Schedule a follow-up appointment in six months for a routine check-up and vaccinations. 5. Monitor for any signs of allergies and administer antihistamines as needed. Closing Statement: The owner was advised to maintain a consistent routine for the dog, including regular exercise and a balanced diet. The importance of dental care was emphasized. The owner was encouraged to contact the clinic if any concerns arise before the next scheduled visit.