C09988405 / invoice 10000

Reason: Ear Infection- Any VetAppointment Notes: Overdue remindersVerified: NoHistory:Presenting for: Maisie and Max presented for bilateral ear infections.Historical Conditions:- Previous grooming: hygiene groom at 16-18 weeks, full groom approximately 22/1/25Diet:Drinking/Urination:V/D/C/S:Skin:Current Meds:Lifestyle Risk Factors:Other:- Owner reports hesitancy with ear cleaning due to fear of going too deep into ear canalExamine:Mentation: BARBehavioural: Maisie described as calm compared to MaxEars: Bilateral ear infections present. Previous discharge noted as pink in colour yesterday.Assessment:Bilateral otitis externaPlan:Additional Discussion:- Discussed ear anatomy with owner, explaining the sharp turn in the ear canal that prevents damage from cleaning- Nursing staff to demonstrate proper ear cleaning technique to owner- Owner education provided regarding safe depth for ear cleaning    Vital Signs    

Reason: Any Vet- VaxAppointment Notes: ------- Sms reply: YesVerified: NoHistory:Presenting for: Two Maltese puppies (Maisie and Max) presented for routine wellness check prior to desexing surgery scheduled for tomorrow.Historical Conditions: Puppies not yet registered under owner's name on national registry; awaiting breeder release.Diet: Eating normally. Both puppies eat from each other's food bowls and take turns. One puppy described as more dainty eater possibly due to underbite.Drinking/Urination: Normal.V/D/C/S: No concerns reported.Skin: Dry pads noted on female puppy. Owner has ordered a cream for treatment.Current Meds: Simparica monthly for flea/tick prevention. Cazitel every 3 months for worming.Lifestyle Risk Factors: Siblings housed together.Other: - Owner reports puppies engage in play fighting- Owner's son wants to take puppies to school for show and tell after vaccinations and desexing- Female puppy described as protective of toys and comb- Male puppy has noted fur breakageExamine:Mentation: BARWt: 3.3 kg (female puppy)BCS: Not specifiedT: Not TakenHR: Normal, no murmurs or arrhythmiasR: Not specifiedMM: Not specifiedBehavioural: Female puppy nervous during examination. Accepted treats after examination.Eyes: NormalEars: NormalOral: Underbite noted in female puppyCardiovascular: Heart sounds fantastic. Nice and clear with no murmurs or arrhythmias.Respiratory: NormalAbdominal: Nice and softMusculoskeletal: Hips and stifles feel perfectIntegumentary: Dry pads noted on female puppy. Fur breakage noted on male puppy.Assessment:Apparently healthy puppies - No concernsDry paw pads - Female puppyFur breakage - Male puppyPlan:Vaccinations:- Vaccination administered today (details not specified)Medications/Treatments:- Desexing surgery scheduled for tomorrowNew Meds/Tx:- Simparica administered today - will take 2 weeks to reach full efficacyDiet Recs:- Advised not to over-moisturize paw pads as they need to harden naturallyAdditional Discussion:- Advised against taking puppies to school during 6-8 month age period due to critical brain development phase that could exacerbate anxiety if stressed during this time- Recommended allowing puppies to sort out their own hierarchy during play fighting unless blood is drawn- Discussed registration process with national registryClient Comms:- Discussed importance of allowing puppies to establish their own hierarchy during play fighting- Advised that siblings of opposite sex may not recognize familial relationship and recommended early desexing- Explained critical fear period at 6-8 months of age and advised against school visits during this time    Vital Signs    Weight: 3.0;       MMColour: pink;       HeartRate: 110;       BodyScore: 5;       DentalGrade: 0;       RespirationRate: 24;       CRT: <2sec;       

Reason: Need A M1 Form CompletedDone    Vital Signs