C09989197 / invoice 10000

History:
Gia reported that Fae has had a gunky eye for the last two days or so, a little squinting and pawing at it. She hasn't seen a vet for years, never had any brachio or entropion surgeries but has been generally well. Gia has had Fae living with her for the last 2 years and has taken over full care from her parents. A few weeks ago she noticed some clicking in the left hindleg and took her to the Bulldog Clinic via Sydney Animal Hospital who said they though she was fine, but advised to do surgery - Gia not sure exactly what, possibly luxating patella, possibly cruciate. Otherwise Fae is fine.

Examination:
BAR, barking and wary but sweet. Vitals unremarkable, Tb not done. Body score 5/9, lean with good muscling, except a little atrophied to hindquarters. Right eye unremarkable, left eye had a mild scleral injection, mild conjunctival injection and fluorescein negative, rest unremarkable. Walking with quite a stilted gait left hind, not keen to fully weight bear when standing still, resented manipulation of the back leg, no cranial drawer but the stifle was moderately thickened and mishapen, slight effusion, slight click, coped with full extension. Left patella was loose but unable to luxate it. Mild to moderate dental calculus. Rest exam Ok.

Assessment:
1. Mild conjunctivitis OS
2. Appears likely to have cranial cruciate disease left hind despite the joint feeling stable, probably has more chronic secondary changes including arthritis.
3. Excellent body condition and health overall.

Plan:
1. Chloramphenicol q8-12hrs OS few days until resolved
2. Discussed considering working up the left stifle further again, but Gia not keen.

History:
Gia reported that overall Fae's skin is improving, lesions mostly seem healed and hair growing back, but one or two are still scaley. Pruritis has continued but has been like this for a long time. Ears much better. Finished the oral antibiotics last week, but still using the flamazine/dex in ears.

Examination:
BAR, but very timid as usual. Body condition Ok as for previous. Spots of hair loss on coat mostly seem improved, hair regrowing, one had scaley dry skin still. Skin under muzzle improved. Ears much improved, thickening in right pinna much improved, slightly red still both pinnae, but otherwise clear. Marked entropion both eyes, slight scleral injection and mucousy discharge.

Assessment:
Overall doing well. Ears responded nicely to the ointment. Pruritis persisting.

Plan:
1. Stop the flam/dex ear ointment for now and monitor closely, need to consider maintenance treatment if recurring prob
2. Use chlorhex spray on the skin lesions when they come up early which may improve their treatment - dispense concentrated chlorhex to dilute and make up in spray bottle.
3. Briefly discussed surgeries again - nares, entropion, other airway assessment, vulval folds.

Dropped off Flamazine/Dex (0.3%/0.1%) ear medication to use - 1ml daily to both ears around 2 weeks, if redness and thickening gone then drop to twice a week until I return to check the ears (when give Bayleigh her boosters)