C10008688 / invoice 10000

Reason: Ears   MDAppointment Notes: Overdue remindersPrevious ear infectionsBeen swimming recently - usually used epiotic but ran outScratching for a few weeks but O noticed really bad last Cried when touched sometimesEDDU normalExam:BAR. Friendly but nervousCV; good rate and rhythm, synchronous pulses, nADResp: clear lung sound bilaterally, NADEyes/Nose: clear, NADEars: R ear clean with mild hair in canal, L ear erythema with brown waxy discharge caught in hair of canalEar cytology:R ear - mild debris and keratinocytesL ear ++ Malassezia presentAssessment:Otitis externa with Malassezia Plan:Dispensed demotic to use for 7 daysDispensed short steroid course as quiet painful and inflamedRv in a weekBought more ear cleaner    Vital Signs    Weight: 30.3;       

Reason: Vacc LJAppointment Notes: Overdue remindersDiagnosis: History: Been wellGets grass seeds in paws, owner checks regularly Examine: BARBCS 3/5Mms pink Dental G1, chipped 203 from dog next door trying to attack him through the fence. Monitor for any swelling ro discolouration of tooth, and extract if under GA for any other reason. Ears/eyes/skin/coat NAD, though a couple of small grass seeds removed from paws. Hair has been clipped short, a couple of dark scabs in interdigital spaces, but no thickening or sinuses, grass seeds have just spiked the skin and been pulled out. Owner to be vigilant for swellings. HR 80bpm NADAbdo NADOrtho NADTreatment:Nobivac KC intranasal vaccOwner worms him regularly at home    Vital Signs    Weight: 29.8;       

Reason: Recheck History: See previous hxO feels much improved as no longer trying to lick at the areaEDUF all okHas 2d ab's leftExamine: BARSinus now scabbed over and much smaller, no discharge presentRectal - tract has disappeared, small amount scarring near skin surface - when palpating accidentally squeezed and scab came off, trace fluid from site but no pusAnal glands empty/not palpableAssessment: Looks more consistent with healing a/g abscess nowPlan: Finish off meds and see how he goes, if recurs then ga and flush/explore    Vital Signs    Weight: 28.2;