C10004133 / invoice 30000

Reason: EarAppointment Notes: Paws App Details:Booking Type: Consultation (extended)Booking Vet: - Any -Booking Notes: Revisions his head and appears to have slipped me thing wrong with his left ear either on outside or inside History: Gotten worse overnight hotspot behind right earShaking head and rubbing it along the ground. OE? Always in the right ear.Neocort appliedBrought in by: VirginiaDiet: Worming: Heartworm:Fleas: Ticks:  Medications:  Other:Vaccines/other meds due or near due: Examine: 1. BCS:    4 /52. Integument: hotspot behind R ear, moderately moist & erythematous3. Musculoskeletal: bunnyhop backlegs - previous spinal dz already known 6. Ears: R ear moderate dark brown cerumen & moderate erythema, L ear very clean and no erythema 12. Behaviour: very good boy13. Other: Laboratory: cytologyL ear: keratinocytes ++R ear: 5 budding Malassezia/HPFTreatment: Showed O how to chlorhex scrub hotspot in consultR ear cleaned with otoflush1st dose dermotic appliedDiagnosis: HotspotR ear malassezia otitis externaPlan:Apoquel 16mg BID POChlorhex SID 7dDermotic R ear BID 7dRecheck in 10dReminders  Updated: YES    Vital Signs    Weight: 23.6;       

Reason: Antinol 240s One Box Pls Appointment Notes: MPOrdered 5/3 SKMeds dispensed1 box of antinol - owner msgd, meds in arrived box LK    Vital Signs    

Reason: CytopointAppointment Notes: Paws App Details:Booking Type: Vaccination / Health Exam Check Booking Vet: - Any -Booking Notes: Cytopointwhen was last cytopoint injection : what dose was given? how long since itchness start again itchness at 1 week  /10itchness at 4 weeks  /10 itchness NOW     /10 History: Wants to start again on antinolWants to start on propalin 			Diet: Worming: Heartworm:Fleas: Ticks:  Medications:  Other (need a veterinary consult) :Examine: 1. BCS:     /5   ideal weight     kg  Weight Loss  Y/N 2. skina) belly b) pawsc) tail base 3. Ears: nad4. Teeth: nad 5. Eyes: nad 6. . heart:   nad  7.  Anal Sacs: not examined 8. Behaviour: 9. Other:    Vital Signs    Weight: 23.7;