C10013209 / invoice 10000

Verified: YESClient: , KayeHistory: Presented 1 week ago with hot spot under ear, treated with topical scrubbing, antibiotics and Prednisolone. Hot spot initially cleared but has now developed active infection underneath scabbed surface in same area in last few days. Currently scratching at affected area again. On Prednisolone experienced panting and lethargy at high dose (1.5 tablets BID), improved when dose reduced. Side effects included polydipsia, polyuria, lethargy and increased appetite with 300g weight gain. Previously had issues with front paws, currently good. Back paws not as bad as previously. Drooling around mouth noted. Not food motivated except for competition with cat (Jefferson). Receives Cytopoint injections - next one scheduled for next Thursday. Dental issues noted previously but not addressed today.Diet: Parasite Control:Exam:Mentation: BARTemp: ?CCardio: HR = PR = bpmResp: RR = pantingEyes: Ears: Bilateral marked hair in ears, otherwise NADTeeth: Gde /4 Other oral exam: MM/CRT: pink/moist, CRT<2sAbdomen: Skin & Haircoat: Active infection under Lt ear with scabbing at surface, pink erythema on ventral abdomen, mild erythema around mouth with drooling noted, front paws NAD, back paws mild erythema. Hot spot under left ear approx 8cm by 4cm in size.Musculoskeletal: Lymph Nodes: Neurologic: Urogenital: Rectal: Did not perform rectal examOther problems found:Assessment:Active pyoderma Lt periauricular region, generalised dermatitis with erythema ventral abdomen and perioral regionDDx:Plan:Diagnostics: n/aTreatment: - Clipped and cleaned Lt periauricular lesion- Prednisolone 1.5 tablets SID PO for 3 days, then 1 tablet SID PO for 7 days, then 1 tablet every 2nd day PO until finished- Antibiotics Rilexine 300mg 0.5 tablet BID PO for 14 days- Continue topical antiseptic BID (O has supply at home)Medication Batch Number: Recommendations & Client Comms: Continue topical antiseptic application BID to affected area. Monitor for side effects of Prednisolone including polydipsia, polyuria, lethargy and increased appetite. Medications can be administered hidden in Meredith goat cheese. Cytopoint injection postponed 1 week to allow current treatment course to complete. Dental disease noted for future addressing.Recheck: Yes, in 2 weeks to assess treatment response and administer Cytopoint injection27/2 NCB no answer mc

Verified: YESClient: KayeHistory: Hot spot under Lt ear x 24 hours. Scratching with hind leg. O applied Cortavance last night to hot spot. Currently managed with Cytopoint injections given approximately 1-2 weeks ago and has been working well. O cleaned ears whilst treating hot spot. Eating, drinking, urination and defecation normal.Parasite Control: Cytopoint injections - last dose approximately 1-2 weeks priorExam:Mentation: BARCardio: HR = PR = 84 bpm Heart sounds NADResp: RR = Lungs NADEyes:clean and symmetricalEars: Bilateral ear canals appear stenotic. Hairy ear canals with brown debris bilaterally and mild erythema.Teeth: Gde 2-3/4 Dental tartar present on canines and caudal teeth with mild gingivitis.MM/CRT: pink/moist, CRT<2sAbdomen: NAD on palpationSkin & Haircoat: 2-3 cm lesion present ventral to Lt ear -slightly erythematous, with some brown discharge bilaterally. Cortavance previously applied by O. Pruritis of feet with some brown discolouration.Assessment:Hot spot (moist dermatitis) ventral to Lt ear. Dental tartar accumulation. Allergic skin diseasePlan:Treatment: - Hot spot clipped and cleaned- Antiseptic wash dispensed - apply BID to wound- Prednisolone and Cephalexin dispensed- E-collar made upRecommendations & Client Comms: Clean hot spot BID with provided antiseptic wash. Administer medications as directed. Keep E-collar on. Monitor wound for deterioration. Made up new estimate for dental and ear flush under GA.Recheck: Yes - in 10 days to see if hot spot improves17/2 NCB no answer mc

Verified: YESClient: KayeHistory: Receiving regular Cytopoint injections with good response, no hot spots this season. Chewing both back feet, particularly noticeable when O settles down at bedtime, front feet not affected. Hx of chronic ear disease, currently not head shaking. Has pet insurance pre-approval for dental and ear procedures. Is a habitual chewer.Exam:Mentation: BARSkin & Haircoat: Coat in good condition. Brown saliva staining on both back feet.Assessment:Saliva staining bilateral back feetPlan:Diagnostics: - n/aTreatment: - Cytopoint injection SC administered todayRecommendations & Client Comms: Monitor back feet chewing, may be habitual behaviour. Dental procedure and ear treatment available when ready to proceed, pre-approval already in place with pet insurance.Recheck: Yes, booked for Cytopoint injection 04/03/2026 at 11:00 with Dr Beth. Dental and ear procedure to be scheduled at O's convenience.