C10009674 / invoice 10000

Reason: Irritated EarAppointment Notes: Molly (Dog) - Rebecca O'Droma - 0419631300 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Louise Schaffer(No Preference)] - Irritated Ear  - Existing customerWeb BookingClient name: Rebecca O'DromaContact number: 0419631300Email address: rebeccaodroma@gmail.comPatient name: MollySubjective and history:Here 2 weeks ago for vaccs Last OE 10/24, since then O has used ear cleaner after bath q2 weeks, also stopped chicken in diet Friends were over on Sat night, possibly ate sausages but they were pork basedPatch of irritated skin on R leg Some discharge from R ear 2 weeks ago- when O cleaned again last night- no waxNot sure if skin irritation/deeper infectionShaking head Objective: BARNervous on entering exam room but sweet temperament, loves treatsBCS 3/5MM pink, CRT <2sec, mod taratr upper carnassials, other teeth excellentHeart/chest okR pinna: marked erythema, mild vol yellow ceruminous discharge, ear canal openL pinna: mild erythema, minimal dischargeRFL large diffuse area of barbered fur w scaling and dermatitis across dorsal aspect distal to elbow approx 10cm x 5cmLaboratory: Ear cytology: R ear: yeast +, cocci +. L ear: clearSTT FL skin: clusters of cocci + occasional rodsAssessment: OE ADSBPTreatment: 1. Apoquel 0.6mg/kg PO BID 3 days then SID 4 days2. Chlorhex FL SID 2 weeks. INI ok for 3 weeks cephalexin3. Dermotic 0.7ml AD BID 10 days then recheck- 1st dose in consult4. E collar as needed to prevent licking- O has at homePlan: Recheck 10 days    Vital Signs    Weight: 26.3;       

Reason: AHC + VaccsAppointment Notes: Molly (Dog) - Rebecca O'Droma - 0419631300 - Annual Health Check & Vaccination [Clinician : Dr. Alex Smeliansli(No Preference)] - Annual check  - Current client Web BookingClient name: Rebecca O'DromaContact number: 0419631300Email address: rebeccaodroma@gmail.comPatient name: MollyReason:Subjective and History: Routine vaccination.Doing well, no health problems reported. Bright, alert and responsive. Eating, drinking, defaecating and urinating normally.Physical Exam: BARVitals WNLsNAD cardiopulmonary auscNAD abdo palpLNs normalEENT normalMSK normalDental 0.5/4Assessment: HealthyFine to proceed with vaccinationTreatment: Routine vaccination. KC SCPlan: Discuss routine health care.    Vital Signs    Weight: 26.3;       

Reason: AHCAppointment Notes: Molly (Dog) - Rebecca O'Droma - 419631300 - Annual Health Check & Vaccination [Clinician : Dr. James Rawson(No Preference)] - Annual check up  -Web BookingClient name: Rebecca O'DromaContact number: 419631300Email address: rebeccaodroma@gmail.comPatient name: MollyHx: EDDU normal.  Diet: scratch- turkey/ lamb. Sometimes licks paws/ itchy. A little better with change diet without chicken. Probiotics to help with skin -not helpingBoisterous and barks other dogs in waiting room. Good with other dogs outside clinic owner said. PE: BAR, euhydrated, BCS 2.8/5, HR 120, panting, temp.- EENT: tiny amount tartarInteg: scant papules on inside pinnae near canal opening. Nothing on swabVery mild interdigital ventral erythemaLns: nadCardio:nadResp: nadAbdomen: nadNo lamenessNormal mentationCytology: Sticky Tape Prep- ventral feet- scant yeast 1-2/hpf. Assessment: ok for vaxMild red feet/ external earsTx: nobivac KC SQNobivac triennial C3 SQOwner elected to hold lepto vax. Plan: chlorhex once weekly ventral feet. Offered elocon for ears today- owner wants to monitor for now. If still bothered may need elocon maintenance for feet/ ears +/- other allergy oral meds or cytopoint.    Vital Signs    Weight: 24.8;