C09984901 / invoice 10000

Reason: 4 Week Recheck MM Appointment Notes: Overdue reminders    Vital Signs    

AC called O to check up on LunaDoing betterEars less redScratching and shaking head lessLess bothered by earsConfirmed recheck appt 2/3    Vital Signs    

Reason: Ear Infection- Itchy, Shaking Head, Gunky- ACAppointment Notes: Overdue remindersHistory:Noticed L ear quite red when O got back from trip Has been scratching it and shaking head Also due for Cytopoint injection - last given in OctHas had prior good response to injections EDUD good otherwise No other concerns No current meds UTD with monthly Nexgard Spectra Examination:BAR. Nervous++ Temp a bit elevated Rest of vitals WNL Femoral pulses SS Oral exam - MM P+M, CRT <2s. G1DD. Doesn't tolerate opening mouth Abdo - NAD. Soft and comfortable. No palpable masses/dilationsMSK - ambulatory x4Integument - HL interdigital skin ok. Not tolerating FL examination Ears: - R ear nil redness. Mild wax discharge on swab - L ear mild redness with mild lichenification. Moderate brown discharge on swab. Ear canal also feels more stenotic LNs - WNL Laboratory:CYTOLOGY ear swabs:R ear - NAD. Nil microorganisms L ear - yeasts+ cocci++ rods+Assessment:L ear infection L ear cleaned with Otoflush in tx room Plan:Cytopoint 20mg 840616 02-27 SC Mometamax Ultra 0.8ml administered into L ear Note left for nurse to call O in 2w to get update on dog's progressR/C in 4w - earlier INI or signs/concerns eg head tilt, circling, ataxia etc    Vital Signs    Weight: 10.00;       MMColour: Pink;       RespirationRate: 28;       HeartRate: 120;       Temperature: 39.4 ;       DentalGrade: 1;       CRT: < 2 sec;