C10000713 / invoice 10000

Reason: SkinAppointment Notes: Polly (Dog) - John Perego - +61420713335 - Consultation Skin or Ear Issues (extended time) [Clinician : Dr. Kate Clair(No Preference)] - Scabs & irritation on skin  - Existing customerHistory:Prev: NGS monthly EDDU WNL. No V/D.Licking vulva and medial HLs.Hx of AD. Physical exam: Heart & lungs: ok MM pink/moist, CRT <2s. LNs WNL.Abdo soft, non-painful.Multifocal crusting dorsum, sternum, medial HLs.Mild perivulvar dermatitis.Recessed vulva. Ears WNL.Cytology:Dorsal crusts- neutrophils +++, intracellular paired cocci.Perivulvar region- ""Assessment:SBP Treatment:Apoquel 16mg PO SID ×5d.Cephalexin 1000mg PO BID ×7d.Malaseb baths BIW ×2w.For ongoing AD - Malaseb baths + Apoquel PRN when pruritus and/or crusting noted.    Vital Signs    

Reason: Tummy RashAppointment Notes: Polly (Dog) - John Perego - 0420713335 - Consultation Skin or Ear Issues (extended time) [Clinician : Dr Anthony Spurrett(No Preference)] - Rash on tummy  - I’m a vlientWeb BookingClient name: John PeregoContact number: 0420713335Email address: peregojohn@gmail.comPatient name: PollyHistory:Rash under her belly Licking around axilla Otherwise well, BAR, EDDU normalDiet: chicken, dry. UTD nexgard spectra Medications: carprofen prn.Physical exam:BAR. Barking MM pink moist, CRt 1-2s LN wnlCardio/resp fine No pain on abdo palpationMarked reduced ROM flexion both stifles Painful on LHL gip extension Pressure sores both elbows Unable to observe other skin disease on abdomen Assessment:Marked DJD. Both stifles + LHL hip Plan:Fish oil 3000mg SID triple strength ongoing Strict exercise restriction. No walking more than 30 minutes. Try keep on lead Weight restriction ongoing. Currently ok weight. Try get to 30kg    Vital Signs    Weight: 32.5;       

Reason: Check For InfectionAppointment Notes: Polly (Dog) - John Perego - +61420713335 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Kate Clair( Preference)] - Check for infection  - Patient for many yearsWeb BookingClient name: John PeregoContact number: 61420713335Email address: Peregojohn@gmail.comPatient name: PollyHistory: Bit more lethargic than usualVomits every day in the morning, bile - before breakfastIf she runs in the afternoon she'll vomit - most of the time eats grass then vomits Throws the ball and usually chases it but just sat down the other day, does that a bit at the park. Gaining weightParasite prevention - NGS Diet: cooked chicken + kibble + fed at night 5pm Carprofen 50mg ONCE daily Increased licking around back end Physical Exam:BAR, happy dog, bit nervousEyes, ears, paws okRecesssed vulva, irritated skin, sticky tape prep - moderate neutrophils in patches, no yeast Plan:Weight loss, wrote O a letter about weight and DJD. Less vigorous exercise and instead more gentle exercise Neocort and chlorhex. Recheck if not resolvingFeed later in the evening in cause vomiting occurs due to prolonged empty stomach    Vital Signs