C09980076 / invoice 10000

Presented for vaccination. 
O notes has switched to Lyka and no more D+ issues. 
Lyka wants them to feed 12hours apart but has started to have small regurg of bile in the mornings prior to breakfast. 
EDUF wnl , no V/D. 
Ear infection resolved nicely no further issues. 

Current meds: nil
Parasite control: UTD
Vaccination status: C3 + Bb/Pi 

Mentation:BAR
MM: pink, moist
CRT: <2s 
DS: 0/4
Skin tent: good skin turgor
LN: wnl
Ears: clear, no malodour or discharge 
Eyes: clear, no discharge 
HR: 128, no murmur or arrhythmia auscultated, = synchronous PR
Chest Auscultation: normal BV sounds and resp effort
Abdo Palpation:  soft, comfortable
BCS:6 /9
Temp: not taken 
Rectal Exam: not performed 
Skin: No obvious lesions, good coat 
Joints/Gait: ambulatory, no lameness observed, full MSK not performed  
Urogenital: nad

Treatment in clinic: 
Nobivac DHP interscap SC (B: 2507101, Exp:02/2027)
Nobivac Bb/Pi intranasal SC (B:2507101, Exp:02/2027)

Problem List: 
fit to vaccinate 
Regurg - Ddx: gastric reflux, empty stomach vs. other 
Recommend losec for 7d, give extra snack before bed around 9pm. 
Follow up call next week. O happy w plan. 

Plan: 
5mg losec SID q7d
Bb/Pi due in 1 year 

Communication: 

O called wanting to book in for annual vax. Last vax was a C3 on 7 March 25 at Greencross Subiaco, but was given an annual C3 so will need C5.
Hx from Greencross Subiaco requested. HB

Presented for -  itchy ears - noted dark spots in ears (fur clumps)
Chews his nails a lot and licks it. Has been doing this since o have had him. Seems to be getting a bit worse. 

EDDU fine 

Current medications:
Parasite control: UTD with flea and worm tx - simparica and cazitel. 

Mentation: BAR
EDUF: no concerns 
Diet: hills adult dermal. Lot of treats. 
MM: pk, moist 
CRT: 1-2s
DS: 1/4
Skin tent: good skin turgor 
LN: WNLs
Ears: bilateral erythema, clumps of hair in canal, yeast smell. 
Eyes: NSF 
Thyroid: WNLs
HR:  100 = PR
Chest Auscultation: normal BV sounds and effort 
Abdo Palpation: soft, non- painful 
BCS: 5/9
Temp: 38
Rectal Exam:  ne
Skin: mild erythema interdigital skin 
Joints/Gait: nsf
Urogenital: nsf
Vaccination status:
 
Problem list: Bilateral OE 

Treatment in clinic: removed hair clumps 

Plan: 
dermotic 0.3ml AU BID for 7 days 

Communication: