C09989312 / invoice 10000

Reason: Recheck Skin And Ears +/- Vac If AppropriateHistory: Finished pred-xReports has been using malaseb wash BIW as recommendThinks improvingWell otherwiseNo issue while was on meds Examination:BAR, normal mentationBCS 8/9P+M mms, crt <2 sec Moderate periodontal diseaseEars -Bilaterally wax build up still presentEars canals not overly redComfortable on sampling TM OKThoracic ausc - No murmur, clear lung sounds, HR WNL, RR WNLIntegument -Moderate errythema of the palmar aspect of both FLs Periocular errythema improved but still presentThickened crusting of the chin area still present Ambulatory on all 4s, no lameness, full MSK exam not performedLaboratory: Sticky tape prep of submandibular area repeated - marked numbers of cocci predominantly ++ occasional coccbaccili appreciated Ears - bilaterally yeasts present in moderate numbers ****Nobivac Bb/Pi given SQ before realising is still on Abs - did not charge for this today. Repeat Bb/Pi once Abs finished.Treatment: 1.2ml afilaria given SQPlan: Clean ears every 2-3d with otoflush - allow ear canal to dry before instilling ear medsPMP 0.5ml into EACH ear BID for 14dExtend Abs for another 2 weeks (total 4 weeks worth)Continue with BIW malaseb wash RC in 14d - ears onlyThen recheck skin after ABs have finished - vac at this time if appropriateRepeat HW inj in 12 mo    Vital Signs    Weight: 22.1;