C10010337 / invoice 10000

Reason: Ear InfectionAppointment Notes: kh** no consult fee as was 30 minutes late due to meeting with management. O very polite about it. History:Possible right ear infectionOtomax at home. Given 2 doses at homeDiet: Raw Kangaroo + raw pumpkin. Dry UTD nexgard spectra Medications: Cytopoint 10mg monthly Physical exam:BAR. Generalised Malassezia smellLN wnlCytology of right ear = cocci ++++, left ear clear Mild scabbing around body. Pedal pruritus. Cytology = yeast ++ Assessment:Atopy. Generalised Malassezia pachydermatitisMalassezia pododermatitisRight ear bacterial Otitis externa Treatment:Fluconazole 50mg SID x 21 days Otomax 0.7ml BID x 10 days Plan:Recheck when cytopoint is due Consider adjunct therapy - apoquel, zenrelia.  Consider diet trial    Vital Signs    Weight: 9.2;       

Reason: CytopointAppointment Notes: eb    Vital Signs    

Reason: CytopointAppointment Notes: ebReason: Cytopoint Injection “Cytopoint is great for controlling itch associated with allergies. But if there are infections on the skin and/or ears cytopoint will not help and other treatment is required”History:Please ask the client: Have you seen any red, moist or irritated skin? NoHave you seen any signs of ear infection such as discharge in the ears, head shaking, or pawing at the ears? No.O reprots general itchiness. If you see these things we need to see the pet for a consult ASAP. Please direct the client to book that appointment with the vet they have been seeing most recently for their skin. It is important to see the SAME vet for recurring skin issues. Treatment: Cytopoint 10mg Injection Given SC by AM in tx room, had another nurse wrap in towel and scoop up, worked well. Had treats back with O after, wouldn't take them before. AM    Vital Signs    Weight: 8.3;