C09990980 / invoice 10000

05/03/2026 HISTORY
Presenting for: Bernie, an adopted dog owned for 12 months, presented for annual health check and preventative care. Owner reports difficulty administering monthly flea preventatives and seeks annual injection alternatives. Also presenting for ear issues - shaking head this morning.
Historical Conditions: Previous separation anxiety when first adopted, now resolved. Can be left alone for small periods.
Current Meds: Monthly flea preventative chews (has remaining supply but dog dislikes taking them)
Lifestyle Risk Factors: Office dog, very calm and social. Occasionally visits Lakes Entrance, Gippsland area. Lives with housemates.
Other: Reactive to large, muscular dogs (German Shepherds) but fine with other dogs. Very calm, social temperament otherwise.

EXAM
Mentation: BAR
Wt: 21.5 kg
Behavioural: Excellent temperament, very calm and cooperative during examination. Takes treats readily.
Ears: Small Malassezia infection present bilaterally, caught early. Cytology confirmed. 
BCS 4.5/9

ASSESSMENT
Malassezia otitis externa - mild bilateral infection
Annual preventative care - healthy dog suitable for vaccination and heartworm prevention

PLAN
Vaccinations:
- Annual vaccination administered 

New Meds/Tx:
- ProHeart heartworm injection administered 
- PMP - 0.8mL into both ears BID until gone

Additional Discussion:
- Discussed Bravecto injection ($362.95) for annual tick/flea control but client opted to finish existing monthly chews first then transition to 3-monthly Bravecto tablets
- With ProHeart injection, only need tick/flea/worm treatments every 3 months instead of monthly
- Discussed training techniques for dog reactivity using high-value treats and distraction games before reactive threshold reached

Client Comms:
- Return for Bravecto tablet when monthly chews finished - can be administered by nursing staff due to excellent temperament
- Continue ear drops until infection resolved
- Maintain tick/flea protection especially when travelling to higher risk areas

05/03/2026 PET INSURANCE E - CLAIM 

Invoice Dates Covered: 05/03

Vet approved:  ML

Date submitted & Initials:  {__}