C09994203 / invoice 10000

HISTORYPresenting for: 4-year-old female spayed Labradoodle (20.3 kg) presenting for ear recheck one month after ear issues. Has been on PMP for 2 weeks, finished treatment about 1.5 weeks ago.Historical Conditions: Recurrent external otitisCurrent Meds: Completed ear drops (PMP) 1.5 weeks agoEDDU normallyEXAMMentation: BARWt: 20.3 kgEars: Right ear appears normal. Left ear has a small black dot on the tympanic membrane, appears to be foreign material (possibly old ear discharge or dirt). No active infection present in either ear. No Malassezia or cocci on ear cytology.Diagnostics: Ear cytology - No Malassezia, no cocci, no microorganisms in either ear.ASSESSMENTResolved external otitis - Previously had Malassezia infection that has now cleared based on cytology.Foreign material on left tympanic membrane - Small piece of material (possibly old discharge or dirt) noted on the left TM. Not causing clinical signs. Too risky to attempt removal as it's directly on the tympanic membrane.PLANNew Meds/Tx:- Elocon Ear drops/lotion  2-3 drops in each ear once or twice a week ongoing for management of recurrent external otitis.Additional Discussion:- Advised to be careful with ears if dog swims, as moisture and heat can trigger Malassezia growth- Foreign material on left TM may resolve on its own, will monitor- Recheck of left ear recommended at time of next vaccination (February/March)- Client to return earlier if any issues developClient Comms:- Next recheck will coincide with vaccines due February/March to avoid additional recheck fee- Return sooner if any ear issues develop before then

HISTORYPresenting for: Luna, a 4 year and 1 month old female spayed labradoodle weighing 20.1 kg, presented for ear problems.EDDU normallyhistory of ears issues.EXAMMentation: BARWt: 20.1 kgBCS: 5/9T: not takenHR: 104R: pantingMM: pink & moist, crt < 2 sec Hydration: NADBehavioural: nice, a bit scared.Eyes: NADEars: Ears red, showing inflammation. left ear worse, some discharge.LABORATORY:Bilateral ear swab: Cocci +++ & Malassezia +ASSESSMENTOtitis externa - Inflammatory ear conditionPLANNew Meds/Tx:- PMP ear drops: 3-5 drops on each ear BID for 2 weeks- Steroid tablets pred 20 mg : 1/2 tablet BID for 2 days, then 1/2 tab PO SID for 2 days then 1/2 tab EOD for 2 more days. , reducing dose to manage ear inflammation.- Recheck in 2 weeks, if clear dispense Elocon for maintenance. 

HISTORYPresenting for: Canine patient presented for intermittent right forelimb lameness following a fall approximately one month ago.Historical Conditions: Patient fell while running in the park on uneven ground, landing on right forelimb.Diet: NormalCurrent Meds: Nails need trimming - patient resists nail clippingOther: - Lameness improves with rest but recurs with activity- Has had multiple episodes over the past couple of months- Initially thought lameness might be related to paw/nail issuesEXAMMentation: BARMusculoskeletal: Right forelimb examined - all joints palpated including digits, toenails, carpal bones. No swelling or infection noted. Bicep tendon palpated and feels stable. Soft tissue injury suspected based on history of high impact fall, improvement with rest, and recurrence with activity.Integumentary: Nails quite long, but dog is very resistant to nail trims...so consider Trazodone prior to nail trim. Or may need sedation.ASSESSMENTRight forelimb soft tissue injury - Likely ligament, tendon, or muscle injury from fall one month ago. Consistent with history of improvement with rest and recurrence with activity.PLANNew Meds/Tx:- Anti-inflammatory medication prescribed to reduce inflammation and pain. Once daily administration. Discontinue if vomiting or diarrhoea occurs.Meloxicam po sid as needed.Additional Discussion:- Restrict high-impact activities including running and chasing- Continue with regular leash walks unless lameness worsens after walking- Walking on pavement recommended to help naturally trim nailsClient Comms:- Discussed possibility of radiographs if condition doesn't improve with anti-inflammatories and restricted activity- Discussed need for sedation for nail trimming in the future