C10003259 / invoice 10000

Reason: Bw On Sat Eye CheckAppointment Notes: Overdue remindersReason: Client Present:CoryNurse:npHealthy Pets Wellness Testing: Done Yes / NoVaccination Type:utdIntestinal worming:ngspHeartworm Prevention:^Flea Prevention:^Tick control:^Microchip:yInsurance and Healthy Pets Plus:hppBehaviour concerns:seems lethargicCurrent medications: doxy apoquel eye drops Current Diet:as beforeType of Shampoo/Frequency:Toileting:eddu__________________________________________________________________________History: Cyst back right leg- salt baths at home and neocortEye check from BWHISTORY:  Recheck consultation for a right eye ulcer and a sebaceous cyst. The owner was advised on Saturday to stop EDTA eye drops by another veterinarian. The owner is concerned the ulcer crater may have enlarged since then. There is a sebaceous cyst that was previously large and expressed by another vet, revealing hard, dark, granular sebaceous material. The owner has been applying saltwater packs and Neocort to the cyst over the weekend. The cyst has reduced in size but has not changed much in appearance. There has been greenish discharge from both eyes, more so from the left eye. Licking at the cyst was noted this morning. Bowel motions have been good.Current meds: Neocort ointment, Viscotears. Previously on EDTA drops. On an unspecified antibiotic (Amoxiclav or Cephalexin mentioned in reference to past sensitivity). Takes probiotics (alternating a powder form and FortiFlora). Has had buprenorphine previously, which causes side effects (staring, panting, barking).Vaccination: Due for vaccination, but it has been postponed.Parasite Prevention: Not mentionedPre-existing conditions: Sensitive gastrointestinal tract, history of reaction to Metacam (liquid).Access to toxins eg. Rodenticide:none EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory:thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological:neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:Oral: normal, no mouth pain, dental score (1-4):not gradedAbdominal: no detectable pain on abdominal palpationRectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: A sebaceous cyst is present. The area was clipped and cleaned. A crater is present within the lesion. Another similar cystic lump was palpated nearby. The area appears inflamed and sensitive. Ears are pink but improving.Lymph Nodes: NSFEyes: Greenish discharge noted from both eyes, more prominent on the left. The right eye ulcer appears similar to previous assessments, no evidence of melting.Demeanour/Behaviour: Bright, alert, and responsive. Very affectionate. PROBLEM LIST:1. Right corneal ulcer2. Sebaceous cyst, inflamed and irritated3. Mucoid ocular discharge, bilateral DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Right corneal ulcerInflamed sebaceous cyst, with suspected secondary self-trauma DIAGNOSTICS:A needle was inserted into the cyst, but no fluid was aspirated.No fluorescein stain was applied to the eye at this stage. ASSESSMENT:Poppet presented for a recheck of a right corneal ulcer and a sebaceous cyst. The cyst has been licked at, suggesting irritation and discomfort. Examination reveals the ulcer is stable and not melting. The cyst is inflamed, likely from a combination of the underlying issue and self-trauma. A needle aspirate of the cyst was unrewarding. The plan is to manage the inflammation and discomfort associated with the cyst and provide supportive care for the eye while awaiting a specialist opinion. TREATMENT:  The area around the cyst was clipped and cleaned.Methadone injection administered SC for analgesia.Meloxicam 0.32ml injection administered for anti-inflammatory effect subqMeth 0.16ml subqMedications prescribed:Meloxicam chewable tablet (lower dose) 1mg, HALF tablet once daily with food, starting 10/03/2026 for a few days.Re-commence EDTA eye drops.Continue current antibiotic.An Elizabethan collar is recommended, especially when unsupervised, to prevent licking/chewing the cyst and rubbing the eye. PLAN:Home into owner's care.A review appointment is scheduled for Wednesday to reassess the eye and the lump. Vaccinations will be postponed again.Referral to Animal Eye Services for an ophthalmology opinion is recommended. Owner to call and enquire about an appointment with Dr. Tom. CLIENT COMMUNICATION:Discussed the importance of restarting EDTA eye drops for corneal protection. Discussed the plan to manage the inflamed cyst, including clipping and cleaning, and providing pain relief and anti-inflammatory medication. The risks of anti-inflammatory medication (Metacam/Meloxicam) in a patient with a sensitive GI tract were discussed; a lower dose and injectable start were chosen to mitigate this. The owner reports good GI health currently and uses probiotics. Advised to start the oral anti-inflammatory from tomorrow. The use of an Elizabethan collar to prevent self-trauma was strongly recommended. The plan for referral to an ophthalmologist was discussed and encouraged. A follow-up visit on Wednesday was organised.Plan: Scripts Needed - Yes or NoRevisit needed - Yes or No - ____ Days pleaseReason: Nurse: -vaccination -heartworm -worming -flea/ticks Exam: Lab: Assessment: Treatment: Plan:    Vital Signs    Weight: 8.3;