C09986458 / invoice 20000

Reason: Needs More PMP Appointment Notes: KM    Vital Signs    

Reason: Review Appointment Notes: Overdue reminders ndHistory:Did fine with medications at homeHavent noticed any limping since started creamExamine: BAR, timid but also friendly, did well for exam Eyes: NSFEars: minimal erythema, minimal discharge, cytology: L ear yeast+, R ear clearIntegument: mild erythema in back paws, front paws NSF Assessment: Resolving OE and pododermatitisPlan: Continue PMP in L ear for another 7 days then stop. To start on long term ear maintenance as per MVSC adviceElocon on hind paws for another 7 days then stop Review if clinical signs recur    Vital Signs    Weight: 22.2;       

Reason: Lameness Hind Leg & Scab On FaceAppointment Notes: csfHistory: Lame on LHL, started a week ago Usually lame once he gets up from lying down Also has been scratching his ears Noticed scab on R jaw Has been to MVSC for skin management before Was given instructions to manage skin but havent been doing much of that recently Due for simparica trio EDDU well Examine: BAR, slightly unsettled, tolerated exam well Eyes: NSFEars: mild erythema bilaterally, small scab noted on R ear, otic discharge +, not stenotic, cytology: yeast ++ bilaterallyOral: Pink MM <2sMSK: no obvious lameness today, comfortable on all limbs, good hip ROM, comfortable spine/neckIntegument: erythema on LHL paw, other paws are mildly erythemic Assessment: Otitis externaPododermatitisNo obvious musculoskeletal discomfortLameness likely a result of pododermatitis Recommend to treat that first and monitor responseTreatment: Elocon to all 4 feet 2-3 times dailyPMP 1ml into both ears BID for 7 daysSimparic trio Plan: Review ears and paws in 7 daysEmail summary of plan from MVSC:Hi Sharon and Brett,I have summarised the skin management plan from MVSC dermatologist as follows:1. Malaseb soak of the feet ONCE weekly (for 10 minutes, dilute 1:10 with water)2. Cortavance 0.5ml to both ears weekly3. Cortavance spray to the top and bottom of all feet TWICE weekly. Stop licking 10 minutes after application4. Continue monthly Simparica TrioPlease let me know if you have any other questions regarding Wicket's management plan. I hope you have a good weekend and we will touch base at Wicket's review next week.Best regards,Dr Benjamin KohBrandon Park Veterinary Hospital    Vital Signs    Weight: 22.7;