C10005889 / invoice 10000

Reason: Skin RecheckHated the cephalexin, difficult to get tablets in.Dermotic easy to do Examine: barEars bilateral minimal waxSkin surrounding L ear much improved - very minimal flaking now. Cytology - nil organismsAssessment: resolved otitis Plan: dex/flam weekly to ensure flare ups under control    Vital Signs    Weight: 13.7;       

Reason: Skin Rash Around Ear And Down Left Side Of NeckWent to get groomed today and groomer noticed scab/crust around the earBathed and brushed today Examine: QARBilateral brown wax down canals, erythematous canalsL ear surrounding skin all flaking and crusted. Cytology - bolateral yeast 5-10 per hpf Assessment: superficial pyoderma from ongoing ear treatment/irritation, otitis externa recurrent. Plan: O happy to use dermotic again, BID for 2 weeksCephalexin BIDPyohex on skin. Recheck 2 weeks.Needs ongoing dex/flam to ensure limited recurrence.    Vital Signs    Weight: 14.11;       

Reason: Ear Recheck +/- Vacc?History: Seems to be doing well. No discomfort at all. Not lots of debris. Eating fine. Energy levels seem generally fine. Didn't eat brekafast this morning, can do this occasionally. No V+D+. Goes between NGS and bravecto the past year.Examine: QAR, anxious but good for exam. MM pink moist, grade 0.5/4 dental disease, CV and chest clear, eyes/ skin/ coat normal. LNs normal. Abdomen soft and comfortable. BCS 7/9 - weight gain 770g. Ears - R ear clear and cofmortable. L ear oily debris all over, pinna hair very matted. No visible wax in the canal. On swabbing piece of dry wax brought out - used for cytology. Not able to scope today. Laboratory: R ear - NSFL ear - no yeast seen at allPinna tape prep - one yeast every 4-5 HPFAssessment: OE resolved finally. Only had two ear infections in the past 2 years so will hold off on interim tx for now eg topical steroids. Discussed allergies and possible tx option if recurrent issue. OK for vacc now. Would like SR 12 also to align with bravecto quantum. Treatment: Protech c2i SC, Pi2 SC, Bb PO. SR 12 SC. Plan: Fenpral 2x10kg tabs every three months ongoing. Billed for free frenpral tabs as BQ given last visit. Weight loss - aim for 13.5kg Fenpral 10kg x 8: 2 every 3m Bravecto Quantum 1ml per 10kg. as per body weight rounded up to nearest 0.1 eg 14.5kg - Given 1.5ml, Billed 1.5ml.    Vital Signs    Weight: 14.37;