C09995806 / invoice 20000

Reason: Appointment Notes: Daisy (Dog) - Derrick Johnston - 0413447223 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Courtney Sloan (Preferred Clinician)] - Recheck around eyes  No, this is not an emergency. I’m a client Web BookingHistory:Hx of AD. Periocular dermatitis, progressing.Possibly mildly pruritic.Physical exam:BAR, taking liver treats.Heart & lungs: ok MM pink, moist; CRT <2s. LNs WNL.Alopecia medial aspects upper & lower eyelids progressing. -> photo attached to file. Eyes WNL, no chemosis or scleral injection.Small amt crusting bridge of nose.Cytology: STP periocular dermatitis-  malassezia, neuts, cocci +Assessment:Suspect AD w secondary inf. Briefly discussed can't rule out immune mediated dz, but unlikely. Plan:Fluconazole 100mg PO BID x14d.Chloramphenicol to dermatitis TID.Apoquel 16mg PO SID x7d.Recheck INI.    Vital Signs    Weight: 24.5;       

Reason: Eye CheckAppointment Notes: Daisy (Dog) - Derrick Johnston - 0413447223 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Courtney Sloan (Preferred Clinician)] - Eye check  No, this is not an emergency. I am a client Web BookingHistory:EDDU ok. No V/D.Chewing paws; O noticed periocular skin changes.No head shaking or ear scratching.Physical exam:Beautiful dog; cautious but friendly; loves her liver treats.Heart & lungs: ok MM pink & moist; CRT <2s; LNs WNL.Mod erythema distal & proximal to both tarsal pads.Mild periocular erythema + alopecia.No scleral inj; no ocular discharge.Cytology: STP feet + periocular WNL.Ear cytology WNL.Assessment: AD Treatment:Cytopoint 40 mg SC.Plan:Periocular dermatitis, discussed may require APQ.INI early next week; O may call to request APQl -> dispense 14 × 5.4mg tabs (10.8mg PO SID x7d).Chlorsig TID if mucopurulent ocular discharge or scleral inj develops.    Vital Signs    

Reason: Ear CheckAppointment Notes: Daisy (Dog) - Derrick Johnston - 0413447223 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Alex Smeliansli(No Preference)] - Ear check  - ClientWeb BookingClient name: Derrick JohnstonContact number: 0413447223Email address: derrickandjo@bigpond.comPatient name: DaisyHistory: Itchy R earOtherwise wellStill licks paws but cytopoint helpedNo GI signsPhysical Exam: BARVitals WNLsNAD cardiopulmonary auscNAD abdo palpLNs normalEyes normalSkin normalBoth ears look ok but v mild redness and build-up in R. No odor Trace cocci <1/10hpf in both earsAssessment: Signs not convincing but will trial dermotic in R ear only (due to redness and slightly heavier discharge)Could be allergy relatedINI consider recheck    Vital Signs    Weight: 24.3;