C09972243 / invoice 10000

**S** Bella - 5yo FS French bulldogPresented for skin itching and irritation, very bothered by her ears as well - shaking her head constantly. has been bothered for about a week or sohas had this issue previously which has been treated with ear ointment - however o struggles to apply at home. due for cytopoint injection as welleddu wnl no v+/d+- PREVENTATIVES: utd with vacc and preventatives - DIET: dry adult biscuits - no change in diet - MEDICATIONS - cytopoint injections every 6 weeks or so Demeanour : barFAS: #INPUT# MM :pink, crt<2 Dental disease: 1 /4 Calculus, 1/4 Gingivitis - Overall -> 1/4 Eyes: clear and clean bilat, no discharge Ears: moderate amounts of dark discharge bilat, smelly, very pruritic, stenotic right ear canal LN: soft and wnl HR: 112, ssfp, no murmurs or arrythmias, RR: pant, clear bv sounds bilat Integ: erythematous between toes, around face, under belly MSK: ambulating well in consult, full ROM in hips and stifles abdo palp: soft and comfortable on palpation BCS: 4.5/9Temp: deferred**A** - ear cytology - malassezia +++ bilaterally, cocci 1+ right side **P** Client Communication / Options Discussed with Owner  - ears cleaned in consult with nurses- 3ml poloxamer admin topically into both canals. - nails trimmed in consult- 20mg cytopoint injection admin sqrevisit and repeat cytology in 7 days time and likely will need second poloxamer dose RW    Vital Signs