C09976553 / invoice 10000

BLOODS:- RBC wnl- WBC mildly reduced- Glucose wnl- SDMA/ urea/ creat wnl- ALKP/ ALT wnl- Pancreatic Lipase wnlPhoned Alana to update, no major concerns from bloods. If vomiting continues, could either switch to GI low fat diet/ hypoA diet vs book in for abdo scan. Alana happy with plan.

Verified: YESClient: MarkHx: In to recheck ears, been going well no head shaking/ scratching. L worse than R. Otherwise OK, does vomit occasionally (once weekly?), never vomits food, usually bile in the mornings. No diarrhoea. Does get fed ham/ cheese every now and then. Otherwise just fed normal dog kibble and loaf sometimes. UTD with vac, flea, worming.PE: BAR lovely boyEyes okEars very mild brown wax at base of ear canal otherwise looking good.MM pink moistTeeth G0.HR lungs nad pantingAbdo palp soft, doesn't appear uncomfortable.IH cytology - L can see single malassezia left, R nadAlso discussed chronic vomit ddx: GI issue/ chronic pancreatitis, other infectious, IBD vs other . Recommended full bloods pls PL today. Owner keen to go ahead. If frequency increases, recommend US scan + B12/ Folate bloods.Plan: Continue dermotic for 3 more days. Dispensed cortavance to use once weekly as maintenance.Bloods taken, will call Mark once results through.5/1/26 NCB/BS: no call as vet called with blood results

Male OHx:Has been shaking head, irritated by ears especially R ear red and waxy discharge noticed a few days ago. Has had OE before treated with dermoticEDDU fine no other concernsPE:Mentation: BAR, anxious not tolerant of examEars: L moderate ceruminous discharge moist erythema of canals TM not visualised, R ear mild ceruminous discharge mild erythema of canals TM visualisedEar cytology: L ear 3-4/5 yeast R ear 2/5 yeast occasional diploid cocciA:Malassezia OE bilaterallyPlan:dermotic 1ml BID both ears for 10dRecheck 10-12d24/12 - NCB Doing well, seem better already which is great. Cont as discussed with the vet and recheck in the new year mc