C09984483 / invoice 10000

Reason: Fasting Bloods And Revisit EyesDue for vacc in March, owner wants to bring forwardExmaine:Eye definitely less mucousy today BUT is the morning....Hard to hear heart over excessive excitement/pantingLeft ear has some gunk (no clinical signs), right ear just inflamed but can see TM okCytology:  yeast 1+ each earTreatment:  cleaned left ear with otoflush then salineVacc C3 nobivac and piBB injectionTOOK BLOODS FOR full profile + fasted triglycerides (has had 18 hour fast)    Vital Signs    

Reason: Recheck EyesEye issues on and off for a few months.  O noticed a cloudy patch on one eye but now a cloudy patch on the other eye tooRubs occasionally but not excessivelyNo issues as a younger dog.Medications are:Amacin bid both eyes.O feel moderately improved on the AMacinExamine:Bright and alert, no blepharospasmNo PLH today in cons (on Amacin), ventral conjunctiva of the LEFT eye is mildly inflamedBoth eyes have central corneal lipidosis/calcinosis/dysgenesis>both eyes approx 5mm by 1.5mm, much more dense on the left eye than the rightNot convinced of entropion today>could be slightest left lower medial but not overly concernedPANTING so not able to successfully examine eyelid margins for distichiaNL ducts look normal and no discharge on pressure here Applied alcaine, mild inflammation palpebral surface of third eyelid left eye, right eye moderate inflammation same spotNeither eye seeing conjunctival folliclesAssessment:Hx suggests allergic conjunctivitis but not follicular todayAlso has bilateral lipiid lesions on cornea (query hyperlipidaeamia verus congenital corneal dysgenesisTreatment:  continue Amacin, trial Hyloforte 3 times dailyDo Calendula tea washing of the eyesPlan: BOOK IN FOR 18 HOUR fasted triglycerides and also full bloods including cholesteroil (so do TAH+ troiglycerieds)>SORRY have not quoted very busy dayAlso check NL ducts at next visit    Vital Signs