C09992198 / invoice 10000

Reason: Needle 12 monthlyAppointment Notes: Booked Online: 04/03/2026 21:55:26 PMSubjective:- Presented for ear concerns and HC + Vacc.- Shaking head and scratching ears with foot today.- History of ear infection one year ago.- No vomiting or diarrhoea. No coughing. NO sneezing. - Receives NexGard Spectra monthly for parasite control.- Overweight body condition.Objective:- Physical examination revealed bilateral ear infections.- Black discharge present in both ear canals.- Chest auscultation was clear.- Otoscopy confirmed erythemic ears ++, brown waxy discharge- BCS 8/9- Dental grade 2Assessment: & Plan:1. Bilateral Otitis Externa (Yeast)- Assessment: Malassezia yeast infection in both ears. Likely secondary to conformational factors (heavy ears) and environmental factors (hot, humid weather).- Cytology was offered to confirm the infective agent for a fee of $52.  Malassezia +++ bilaterally. - Plan for treatment: Prescribed PMP ear drops. First dose administered in consult. Advised to clean ears with Epi-Otic daily then apply drops twice daily for one week. Discussed cleaning technique.- Follow-up care: Re-evaluation if symptoms do not resolve within one week.2. Weight Management- Assessment: Overweight body condition.- Plan for treatment: Advised to reduce food intake by approximately 25 percent. Advised to cease all treats.- Follow-up care: Encouraged to use the clinic scales for regular weight monitoring.3. Routine- Vaccinations given: Vanguard C4 and Vanguard CCl SCAdditional Notes:- Discussed that maintaining a lean body condition can extend lifespan by up to 2 years.- Educated owner on correct ear cleaning and medication administration technique.    Vital Signs    Weight: 16.4;       

Reason: Vaccination & Health CheckAppointment Notes: Overdue reminders  ------- Sms reply: YHistory:EDUD fine. On NGS monthly. Diet wet food mostly. Some dried food in morning. Plus treats.Examination:Dental drade 1. Clac. Some chipped teeth (bone chewer). Lnn wnl. Chest nad. BCS 7/9 overweight. Skin fine. Ears nad. Few dermal lumps, wart like appearance. One on dorsum of neck and one near tail base. Assessment:Fine for vacc    Vital Signs    Weight: 15.3;       

Reason: VaccinationAppointment Notes: ------- Sms reply: YO no concerns at home, DUDE normal, eats normal dog food but sometimes treats and cooked veg/met also, o mentioned coughes about once per day like trying to clear throat, chases ball good exercise tolerance, no other concerns.On CE is BAR, mm pink, tartar build up on teeth reccomend dental, think likely scale and polish only, chest ausc NAD no heart murmur or resp abnormalities, o to monitor cough for changes at home, abdo palp soft and comfortable, BCS 7/9 adv cutting food down and increasing exercise, bring in to weigh more frequently, coat and skin WNL, a couple of small warts, lovely boy! UTD with monthly HW trt, C5 vacc given.    Vital Signs    Weight: 15.3;