C09997844 / invoice 10000

DIAGNOSIS:
Irritated L ear

HISTORY:
presented by Sarah
Dog has been scratching at left ear over weekend
Skin is generally good but does sneeze a bit and hx of insect bite reaction
No hx of ear infections

EXAMINE:
B&A
Likes treats
1/4 dental score - small amount of tartar on teeth. No gingivitis
L ear not inflamed, no dishcarge. But small calcinosis cutis lesions middle of inside of pinna (cause?)
No wounds/lesions on rest of ear
Otoscopic exam - ear canal clear, not inflamed. Small amount of wax deep near TM (intact). Could be small gs trapped in this but think probably just hair
R ear - similar with small amount of wax deep in canal

TREATMENT:
Dexason inj
Ears cleaned with otoflush

PLAN:
INI consider sedation to retrieve wax

SUBJECTIVE: 10:50am: JG
: Presented by O' Callum and Sarah
: On a walk about 25 mins ago and backed head abruptly out of the grass as if had been stung or bitten by something. Immediately afterwards, began licking lips and pawing at mouth. Gagged/retched in the car while in transit to ECVH - Was not vomiting (though vomited and salivated last night). Moose seems more settled now and is no longer licking his lips or pawing at his face

OBJECTIVE:
: T=39.0C; B&A; normal gait; normal PLRs and palpebral reflexes; normal gag reflex; normal m-m's colour; NAD on cardiothoracic exam. Focal 3mm approx diam area of inflamed/hyperaemic gum tissue in the L Mx incisor buccal mucosa. Nil obvious oral/gum bee stings or FB's 

ASSESSMENT:
: Acute facial irritation during an outdoors walk this morning; Focal L Mx incisor buccal mucosal inflammation: Suspect insect/bee/wasp sting

PLAN:
: Rx: Dexason Dexadreesson 2mg/ml @ 1.2ml s/c; Niramine 10mg/ml @ 1.2ml s/c
: Recommended vigilant monitoring indoors for 24hh
: R/V INI or if O' are otherwise concerned

SUBJECTIVE:Presented by Callum today.  Check up and vacc.  Has been well in himself - dew claw issues seem to be resolving OK.  
Is a little overweight - O aware.  

OBJECTIVE: mm pink, CRT<2, eyes/ears -  NAD, mouth - mild tartar,   heart and chest - NAD,   abdo - NAD   T- not taken today.  


ASSESSMENT: OK for vacc. 


PLAN: Canine cough vacc given today.