C09996408 / invoice 10000

Reason: Ulcer On Eye. GunkyHistory:Yesterday noticed R eye milky and sore DUDEDietMedicationPrev medical hx Parasite prophylaxis Vaccines Examine:_ARBCSMM pink CRT 1s TeethHR_ + ausc WNL RR, resp sounds + effort WNLAbd palp NADPalpable LNs WNL Eyes NAD Ears NAD Skin/coat NAD Musculoskeletal NAD Neurological NADTemp Problem list:Differential diagnosis:Laboratory:Assessment:Treatment:Plan:    Vital Signs    Weight: 17.4;       

Reason: Supply DrugsCommunication: Owner confirms is currently giving as per labelConfirmed this matches current medication instructions- yesLast veterinarian visit DATE:...........11th august 2025Medication prepared by ...............Fyl    Vital Signs    

Reason: See Unmatched Web Bookin Appointment Notes: DS No file, left msg Bane (Dog) - Consultation [Veterinarian : 2 Consult(No Preference)] - Lump above tail. Has been treated for fungal infection previously but the lump has remained. Sensitive to touch.Web BookingClient name: Gemma RyanContact number: 0456771368Email address: gemmaryan34@gmail.comPatient name: Bane Original Appointment Type: ConsultationHistory:Presents for lump on tail baseTail fungal inf seems healed, but O still worried as often swells a bit and then normal againAlso seems to have an ear infection nowAlso licks feet and scratches body a lot, has had apoquel for two weeks a couple of months ago and that seemed to help a lot.Otherwiswe eating and drinking well, no vomiting or diarrhea, no changes in activity level nor coughingExamine:Active and alertEyes and ears cleanCrt<2, pulse normal, mm pink and moistHeart and resp sund normalAbd palp: soft and painlessLnn feel normalTail: amputated tail base with folds/pocket formation: no signs of infection/inflammation, non painful to touchCytology ear: cocci ++ both left and right earProblem List:DIfferential Diagnosis:Tail base swelling: - allergy/sec infection- tumor- disk herniationTreatment:Dermotic both ears BID 10daysApoquel 8mg SIDPlan:- Fungal infection in tailbase folds seem to have resolved from previous treatment - As allergic component that responded well to apoquel in the past, restart apoquel and this time longer than 2 weeks.- Explained tail base has folds which would make it the ideal location for secondary bac/fungal infection with swelling/inflamm as a consequence. To review if starting apoquel might also cause occasional flareups of tail to disappear- Ear infection to be treated with dermotic, with apoquel as an added component in treatement for the primary cause- If tail keeps swelling even after using apoquel for 4-6weeks then revisit for additional diagnostics tail base, i.E. Biopsy or even xray if we suspect disk herniation as a potential cause for the pain/swelling    Vital Signs