C09991703 / invoice 10000

Reason: Lump On Stomach.  SpAppointment Notes: Overdue remindersHistory:Presented with large red mark near groin/tummy area noted 2 days ago, now significantly reduced in sizeInitially appeared as red area with central dot, surrounding erythema and possible swellingOwner concerned about possible tick bite initiallyNo change in appetite or behaviourNo discharge or pus observedArchie tends to develop small pimple-like lesions periodicallyLast grooming session 2 weeks agoBoth dogs acquired during COVID as puppiesRecently changed diet due to fussiness with commercial dog foodChronic ear issues, particularly left earPrevious ear treatment with steroid drops was effectiveExamination:Behaviour: BAR, NADCardiovascular: NAD. Pink moist MM CRT <2 and no murmurs detectedRespiratory: NAD, normal effort and bronchovesicular soundsGIT: comfortable, pliable, no mass effectsMusculoskeletal: No pain on palpation of any joint or long bone. Ambulatory 4x4Neurological: NADIntegumentary: Minor scab with bruising in L groin area, significantly improved from initial presentationLN: NADOral Cavity: NAD. Grade 0/4Ocular: NADAural: Bilateral ear infection present, left ear particularly affected with malodorous discharge and significant debrisUrogenital: NADEars: Bilateral otitis externa with purulent discharge, particularly severe in left ear with strong odourAssessment:Minor skin lesion/scab in groin area, likely insect bite or self-inflicted trauma, resolvingBilateral otitis externa with suspected mixed bacterial infectionPlan:Ear cleaning by nursing staff to remove debrisTopical ear medication to be dispensed, once daily application preferred due to compliance issuesMonitor skin lesion, should continue to resolveReturn if ear condition worsens or skin lesion deterioratesClient communication:Discussed likely causes of skin lesion including insect bite or self-traumaExplained ear infection findings and need for treatmentAdvised once daily ear drops more manageable than twice daily dosingDiscussed compliance challenges with ear treatment and strategies for administration    Vital Signs    Weight: 6.8;