C09980305 / invoice 10000

Appointment Notes: sore paw RHHistory: In the past day has been licking freq at RH paw.Also occ scratching at ears/neck.Was using Malaseb wash once a week, thought using more freq was making him irritated.Examine:Basket muzzle size 7 placed to examine ears/paws.Ears - bilat mod matted fur at entrance to ear canal, not tolerating much handling.O consented to sedation.Treatment:Sedation: domitor 0.25ml & butorphanol 0.25ml IM.Good sedation.Topped up with Alfaxan IV to effect.Ears: swabs taken for cytology -> bilat budding yeast ++ (L worse).Cleaned with Epi otic.Osurnia applied to each ear.RH paw: clipped up.Mild/mod erythema of skin on dors surface of digits 2-4.Sticky take test = cocci ++, occ yeast.Cleaned with Malaseb.Dermotic applied.Reversed sedation: antisedan 0.25ml IMDex 2.3ml SCPlan:Paws Meriderm wash SID x 5-7d.Dermotic onto skin BID x 7d.Return in 1w for 2nd osurnia and recheck skin on paw.     Vital Signs    Weight: 23.3 (Patient Update);