C09980084 / invoice 10000

Reason:  Ear flush under anaestheticHistory:  See prior entry. Daisy presents today for ear flush and excision of a pedunculated canal mass under GA. Old girl, struggling with flooring and grip. But otherwise, eating and toileting well. Examine:Right canal still malodorous but Laboratory:HCT 37.2 % 37.3 - 61.7RBC and HGB low normal. Premed: methadone 0.2mg/kg + medetomidine 5mcg/kg together IM inj to good effectContinous monitoring HR, RR, BP, SP02Pedunculated ear mass excised at base of stalk with scalpel blade -> haemostasis with pressure alone. No sutureSmall (<2mm diameter) wart snipped off from scalpRight TPM ruptured Ears flushed with saline until clear - instilled 2 BNT in both canalsTreatment:One-off carprofen 4mg/kg SQ injPlan:Continue carprofen oral tomorrow Revisit in 7d for repeat BNT    Vital Signs    

Reason: Moved From 4pm To 1230 Due To Not Enough TimeAppointment Notes: VETSTORIA:  Daisy (Dog) - Rebecca Jung - 0409508844 - Consult [Veterinarian : Dr Ruth Brophy(No Preference)] - Infected ear No, I do not need a skin/ear/eye consultation.Web BookingClient name: Rebecca JungContact number: 0409508844Email address: rjung79@gmail.comPatient name: DaisyReason:History:Daisy presents today for suspected OE. Has had before. No head shaking or scratching. Did get groomed a month ago, but doesn't swim or anything. Still eating and toileting well. Examination:HR -  108  RR - panting   Temp -  not attempted   CRT - 1-2s    mucous membranes - pink and moist Examine:- Oral cavity - NSF.- Dental Score - G0/4 - Ears/ eyes/ skin - right ear fetid, external canal caked in malodorous dark brown exudate, occluded by a pedunculated, multilobulated cutaneous mass (likely benign tumour), both canals swabbed for cytology -> left ++ malassezia, right ++ malassezia, ++++ cocci, ++ rods with occasional neutrohil- LNs - Peripheral LNs WNLs. - Thoracic auscultation - No audible murmur or arrhythmia, normal bronchovesicular sounds. - Abdominal palpation - Soft, comfortable, no palpable anomalies. - MSK - No lameness observed, complete MSK exam not performed. - Neuro - Appropriate mentation, no ataxia. Complete neuro exam not performed. - Genitourinary - NSF.Assessment:Bilateral OE with mixed bacterial/yeast colonisaton (right severe). Spoke to Rebecca, starting dermotic now, but due to severity, don't have much hope will resolve. The right canal is almost completely occluded by a pedunculated mass which will predispose to recurrent OE. After this, recommend ear flush under sedation, and excise the mass. Treatment:Dermotic 1mL down both canals for 10dPlan:Booked in for flush and lump on March 3    Vital Signs    Weight: 30.0;       

Appointment Notes: VETSTORIA:  Daisy (Dog) - Rebecca Jung - 0409508844 - Vaccination [Veterinarian : Dr Rachel Lee(No Preference)] - Vaccination -Web BookingClient name: Rebecca JungContact number: 0409508844Email address: rjung79@gmail.comPatient name: DaisyHistory: Struggling with mobilityEating and drinking well otherwiseToileting wellVacc Pi/BB First YearPi/BB in 12 monthsTri C5 in 24 months Examine: Weight - 31Teeth - G2/4Coat condition/ Skin  - Normal healthy skin coat. Pedunculated ? Lesion on right side close to shoulderHeart/Lungs - Normal heart and lung sounds Abdomen - Soft and comfortable abdomen Musculoskeletal - Stiff gait and normal ambulation, full MSK not performed Health concerns - NOCCytology: +++ RBCsA few neutrophils and lymphocytes Treatment:Vaccinated - Injectable Pi/bbCarprieve 50mg SID for mobility ongoing Monitor mass ongoing, if any irritation/rapid growth revisit    Vital Signs    Weight: 31;