C10012554 / invoice 10000

Reason: R corneal ulcer Presenting Concerns:  Fuji presented for assessment of her R eye. The owner reports that for the last week and a half, the eye has been weeping. The weeping has recently decreased, but the eye often appears squinty or only partially open when she is relaxed.    Historical Conditions:-   History of pancreatitis. o feeds low fat diet to manage.  Current Medications:-   No current medications.ObjectiveMentation: BAR  Wt: 15.8kg  BCS: 5/9  MM: pink/moist. CRT < 2sec.  Hydration: Normal  Eyes: R eye: Significant conjunctival and scleral hyperemia noted. The patient has mild blepharospam. A fluorescein stain test was performed and revealed a 3 x 1.5mm small ulcer on the lateral aspect of the cornea. The fundic exam was within normal limits. L eye WNL.  Ears: Clean with no discharge or erythema AU.  Nose: Clear, moist without discharge. A small 3mm skin tag is present on the left side of the nose.AssessmentR Corneal ulcer - Diagnosed via positive fluorescein stain uptake. This is consistent with the clinical signs of blepharospasm, epiphora, and conjunctival hyperemia.PlanDiagnostics:-   Fluorescein staining of the OD was performed in-clinic.  Medications/Treatments:-   0.6ml meloxicam injection was administered s/c.-   Dispensed Optichlor: Apply a 1 centimeter strip into the R eye BID for 5-7 days. Instilled first dose in cons to demonstrate technique to o.-   Dispensed oral meloxicam liquid: Administer 1 mL PO on food SID for 5 days, starting tomorrow morning.  Additional Discussion:-   A recheck examination is recommended in 3 to 5 days to ensure the ulcer is healing properly.-   Discussed that most corneal ulcers heal without complication. However, if healing is delayed, further intervention such as debridement with a cotton swab or, in rare cases, surgery may be necessary.-   Advised the owner to use an Elizabethan collar if Fuji begins to scratch at the eye.-   The owner was informed that the green fluorescein dye may drain from the nose, which is a normal finding but can stain fabrics.    Vital Signs    Weight: 15.8;