C09978828 / invoice 10000

Reason: R/V for skin + malaseb bath 

History:
Bacterial/Fungal Pyoderma concentrated around dorsal neck, however, diffuse overgrowth. Malaseb bathing with RVN's weekly to ensure thoroughly dried post bathing & treatment being adhered to
BAR, EDUD with NIL concerns. Taking meds as Rx

Examine:
EENO: Paralysis of tongue (hangs out to the left), hyperkeratosis of the nasal planum, scleritis (mild today in comparison to previous)
MM/CRT: PM/1-2s
Abdo: Relaxed; NIL discomfort on manpiulation
MSK/Gait: Ambulatory; 0/5 Lameness noted
U/G: 2 x Descended testes
Integ: Mild hyperaemia of the worse affected regions, however, overall markedly improved skin. Some mild flaking of the skin noted ?2* to barazone?

DIAGNOSTICS:
1. In-House Skin Cytology
A: Yeast/Cocci <12/HPF; Considered normal floral population

PLAN:
Reduce bathing to fortnightly for the next month, then attempt to reduce to weekly. 
Aqeous Chlorhex wipes 2x weekly ongoing for control of bacterial load; ensuring to play close attention to nasal rope and skin folds
Water Wipes NIGHTLY ongoing

ONGOING PLAN:
Can bathe fortnightly for the next month with RVN's to ensure adequate contact times, rinsing and drying of skin folds