C09995859 / invoice 10000

Appointment Notes: acu SubjectivePresenting Concerns:  Ollie presented for a recheck of his chronic back condition and for a new issue of scratching at his ear.  Came in for acupuncture but after examining ear was not suitable for needling  Skin & Coat:-   The owner reports that Ollie has been scratching his ear for the last couple of days.  Additional Information:-   Ollie is reported to be much brighter and more willing to play and walk since his last treatment.-   He has been grumpy with other dogs that approach his hind end.-   His exercise is being managed with short walks, and the owner sometimes uses a pram.-   An appointment with a rehabilitation therapist is scheduled for April.  Point of Care Diagnostics:-   Ear Cytology:  Rt ear - A large number of yeast organisms were identified. 20-30hpfLeft ear normalAssessmentYeast Otitis Externa – Diagnosis confirmed by in-house cytology revealing a large number of yeast organisms.    PlanPending Diagnostics:-   A follow-up abdominal ultrasound was recommended to re-evaluate the liver.  Medications/Treatments:-   An application of keto/dex poloxamer gel 1ml into Rt ear  was administered -   Acupuncture was attempted but discontinued due to patient stress.-   A recheck appointment is scheduled for next Wednesday for acupuncutre and Friday for nurse to apply the second dose of 1ml keto/dex poloxamer.  Additional Discussion:-   It was discussed that an MRI for the back is not indicated at this time as Ollie is clinically improving. Referral centres are unlikely to perform the procedure on a patient that is not deteriorating.-   The current management plan for his back was reaffirmed, including gentle exercise, future physiotherapy, and pain relief as needed.    Vital Signs    Weight: 9.2;