C09973304 / invoice 10000

Reason: Spey + Hernia Repair/check Ears Appointment Notes: Overdue remindersReason: Mature speyExamine: ears discharging PMP, otherwise settledHs normalStenotic nares, gen breathing ok. Presented by owner's mum, so no nare sx todayVulva not engorged. Small umbilical hernia presentTreatment: ACP    mls s/c + Methone     ml s/c premed + metomideGA: Alfaxan/Isoflurane. IV drip.Routine spey with hernia repair within  primary incision2-0 double ligature son pedicles and uterine body with transfixion.Routine body wall, s/c and intradermal closure.Vax at post op check.    Vital Signs    Weight: 13;       

Reason: Spey + Hernia Repair/check Ears Appointment Notes: Overdue reminders    Vital Signs    Weight: 13;       

Reason: VaccinationAppointment Notes: COHistory: Presented for vaccination. Maple has been doing well, occasionally scratching head. EDDU normally. Diet: billy and margot. ST monthly. Wanting to get desexed. Last heat in Oct. Examine: General demeanor: BARBehaviour: friendly Oral exam: MM pink, moist, <2 sec CRT, Dental grade: 0.5/4 Hydration status: good Ears/eyes/nose: ears waxy bilaterally thick black wax and inflamed canals L >R Cardiovascular: Regular rate, rhythm, no murmur auscultated Respiratory: Regular respiratory effort, bronchovesicular sounds clear bilaterallySkin/coat: small 4mm raised bump RHS shoulder another more dorsal-follicular cyst vs scratch?Peripheral Lymph nodes: Palpate wnl Abdominal palpation: soft and comfortable Genitourinary: large non-reducible umbilical hernia present. Rectal/Anal glands: Rectal not performedMusculoskeletal: No neck or spinal pain detectableNeurological: Normal gait, mentation and posture. Full exam not indicatedAssessment: In-house cytology: malessezia +++ bilaterally L>RPlan: O to start PMP bid for 10d then recheck. Can clean ears prior with saline (O has at home). Postpone spey + hernia repair to the following Monday 02/03 due to current ear infection. Advised to fast overnight. Can recheck ears, trim nails then. Can do vaccine at desexing or ideally at post op check. Advised to avoid getting ears wet.    Vital Signs    Weight: 13.4;