C09975492 / invoice 10000

Reason: L Ear Flush-> Neptra And S/pTODAYS CONTACT:1.  04505517882. Procedures:- Ear flush- dental- prega- ears- nails Laser Therapy Consent: NPre-authorisation:  Extra work declined, unless approved by phone contactEstimate Checked with owner: Y / N  (Check estimate is in date and all procedures being done are on there)Fasted: Y Owner reports: - doing well no concerns Blood / urine tests:- prega Medications/Last Given:-      nil                          -      RECORD WEIGHT ON RXWORKS / PUT IN PROCEDURES LIST Admitted by :Diagnosis: Otitis Externa - L yeast previously recorded and R same but not as badSubjective: Previous treatmet summary : Dermotic and epiotic SISLaboratory: Ear Cytology :Pre Ga Bloods : NADTreatment: Sedation Dexmedetomidine / Methadone IM: IV fluids Open Vein Alfaxan IV / ET / Iso / O2GA report:Externa canal / pinna clipped and cleaned Open ended tom cat catheter + saline flush both ear canals and otoflushTympani condition :  L =  marked ulceration and cerumen adhered to canal, TM intact         R =  marked ulceration and cerumen adhered to canal, TM intact         As per CO treatment planL ear - neptra, and R ear dermotic 0.6mLConversations: Owner called by:  SH   At time:   515pmDischarge booked?: 645pmPlan: Home pm Ear cerumen build up and inflammation and ulceration quite significant, may need referral to dermatology INI for otoscopic examination of TM and potential C+SPost op check due +3Recheck + Ear cytology due + 3-4 weeks    Vital Signs    Weight: 12.4;       

Reason: L Ear Flush-> Neptra And S/pReason: Communication call - Preoperative Phone callConversations: Owner called re Surgery booking +1Instructions to owner - food to be removed from 8pm - remove water the morning of surgery - please bring any medications patient is on - ensure that if the patient requires PVP's that they are given - mention pre GA bloods - have they been done or to be done- Discuss GapOnly and add insurance details - advise of initial payment ( if required ) $1201.80- ask preferred d/c timePlan: Admit via Vet / Nurse at :      8.30     am ( appt made ) Preferred Discharge Time:Confimred    Vital Signs    

Reason: Follow Up AppointmentAppointment Notes: Arlo (Dog) - Recheck Appointment [Veterinarian : Dr Clare O'Connor (Preferred Clinician)] - Follow up appointment after treatment administered as per last consultation - Web BookingClient name: David MclaughlinContact number: 0450551788Email address: dmclaughlin25689@gmail.comPatient name: Arlo  ------- Sms reply: YES  ------- Sms reply: YesDiagnosis:  50% imrpoved yeats OE L, but not letting O treatSubjective: Owner reports:Didnt like the ear cleaner, tenderGetting a bit aggressive with O Stopped for a few daysThen restrated with the demrotic and has been better Seems much better now , much less smell Medications:Dermotic, last in yday Objective: Mm pink, g1-2 pl caudal, g0 rostralL ear red sand tende,r cytoogy 2+ yeats clustersR ear min dc 1+ yeatsm, not painfuilRets skin okChets okAssessment: Imrpoved but not resolved yeats OE, O having difficulting medicating with dermoticTreatment:  Plan:Ear flush L, clean R, then s/p, (give 30mins for ears to dry), then neptra L and inhouse dermotic 1 dose R Warned re LA side efcet with neptra    Vital Signs    Weight: 12.5;