C10000729 / invoice 10000

Reason: cytopoint

History:varied diet , itches ventrum and ears 
scoots - been getting Ags expressed every 3 weeks!
 no probs reported DUDE active 

Current medications: no

What Preventative health cover is being used and do you need to purchase any today? 
Worming: UTD
Flea control: UTD
Heartworm Prevention:
(TWP discussed: Yes/No)

Examine: 
Mentation: BAR
BCS   4/9      
MM:       P+M           CRT: 1-2s
HR:     100        RR: WNL / no adventitial lung sounds 
Dental Stage: 1
Temperature: NE
Gastrointestinal: NAD on palpation – soft , relaxed no palpable masses
Integumentary & lumps (measurement, location): nad
Musculoskeletal: NAD – all joints and limbs – Rom WNL, no lameness,, no crepitus , pain or instability 
ears - L ear mild erythema EAM ventral pina and canals , R ear similar but milder Cs's cf L ear 

Assessment:
low grade inflammation ears

cytpoint 10mg 
elocon 1-2 weekly ongoing 
flush ears prior 
adv kibble and SPD soft food olny - limit variety aim to find combo that helps control AGs 
also has pysllium husk 

Both anal glands expressed in consult room
Both very full and not easy to squeeze.
Both filled with brown liquidy contents. 
O good at holding- p very good.
MJP

MP expressed both anal sacs, both very full but easily expressed.