C09984943 / invoice 10000

Appointment Notes: Vx + health check + Cytopoint + wanted to discuss possible urology results? - CL 13.5kgVerified: YesHistory:Presenting for: Maisie, an 8-month-old French Bulldog, presented for vaccination and ongoing management of bilateral otitis externa.Historical Conditions:- Bilateral otitis externa - previously diagnosed and treated; ear cleaning performed at a prior visit- Urinalysis performed at last visit (results reviewed at that time)Skin:- Client reports known exposure to possum faeces in the backyard; considered unavoidableCurrent Meds:- Preventative ear drops (otic) - 0.75 mL BID once weekly; client unsure of ongoing duration, reports product may still be at homeLifestyle Risk Factors:- Outdoor access; backyard with possums confirmed- New baby in the household- Camping/caravanning with owners; exposure to waterways (swimming)- Lives with owner's family; no other pets mentioned in householdOther:- Owner's sister-in-law has a French Bulldog with a spinal deformity (hemivertebrae suspected); dog is 2 years old, non-ambulatory in hindlimbs, being referred for spinal surgeryExamination:Temperature=38.2, Pulse=92/min, Respiration=20/min, MM=pink, CRT<2sec. Ears:- Bilateral otitis externa confirmed; ears noted to be difficult to clean given conformation- Client reports overnight head shaking/ear flapping ongoingAssessment:Bilateral otitis externa - Chronic/recurrent; ongoing preventative otic therapy in place. Client uncertain about long-term maintenance protocol. Underlying allergic disease possible given breed predisposition and recurrent nature.Ok to vaccinatePlan:Vaccinations:- Core vaccination (C3 or equivalent) - administered today- Leptospirosis + canine coronavirus combination vaccine discussed - $20 additional cost; requires 2-dose series given 2-6 wks apart. Client advised first dose can be given today and booster scheduled on return from travel. Client leaving Monday; booster timing remains within the 2-6 week window on return.- Leptospirosis: spread via urine/faeces of rodents; contaminated groundwater a known source; recent outbreaks reported in Melbourne including Flat area. Recommended given outdoor lifestyle and known wildlife/possum exposure.- Canine coronavirus: distinct from COVID-19; noted to be common in dogs.- Vaccine well tolerated; no significant adverse effects anticipatedNew Meds/Tx:- Reissue/refill of preventative otic solution - 0.75 mL per ear BID once weekly, ongoing (lifelong maintenance)Changes to Existing Meds/Tx:- Clarified that preventative otic drops are to be continued long-term (lifelong), not just for a few wks as client had assumedAdditional Discussion:- Medicated shampoo (antifungal/antibacterial) discussed as adjunct for skin/coat management given breed predisposition to skin and ear issues- Discussed that Maisie's ear conformation makes ongoing maintenance challenging but essentialClient Comms:- Confirm leptospirosis/coronavirus booster to be scheduled 2-6 wks after first dose, on return from travel- Reinforce lifelong use of preventative otic drops at 0.75 mL BID once weekly- Discuss medicated shampoo use at next visit or sooner if skin concerns arise    Vital Signs    Weight: 13.5;