C10021011 / invoice 10000

Reason: Vax. Eye Recheck. Ears left one. Cyst on RH. More Bupe pls?Client Present: CoryNurse: AnitaHealthy Pets Wellness Testing: Done Yes / NoVaccination Type: Doing today?Intestinal worming:Heartworm Prevention:Flea Prevention: UTDTick control:Microchip: on fileInsurance and Healthy Pets Plus: HPPBehaviour concerns: noCurrent medications: Dermotic finished 2 days agoCurrent Diet:Type of Shampoo/Frequency:Toileting: Normal. No v+ or d+ EDDU__________________________________________________________________________  Subjective: - Revisit for review of left eye ulcer and overall condition. - On Monday (09/03/2026), presented with a concerning appearance of the left eye. Owner was worried. - Currently on doxycycline for 5 days (4 days remaining) and Ocuflux regularly for one week. - Also receiving an anti-inflammatory chew (half tablet), started yesterday -  metacam chew 1mg. Following the first dose, was reluctant to get up the next morning until 1 PM, doing much better now - Owner administered a full dose of bupe TM one night for a "bad night", which helped settle the animal. - No head shaking observed since wearing an E-collar. Head shaking was noted briefly during a walk this morning when the collar was off. - Owner reports a single episode of vulvar licking on the night of the "bad night". Vulva appeared very red. Owner applied cream (unspecified) once. Vulva appeared normal the following morning and no further licking has been observed. - Ears appear normal, not hot or warm. Owner notes recent lawn mowing in the area and is monitoring for any skin flare-ups, as there is a known sensitivity to fresh grass.  Objective: - Physical examination findings: - General appearance: Bright, alert, and responsive. Seems happier than on previous visits. Responds well to cuddles. - Left Eye: The ulcer crater appears unchanged in size. It has not improved but has not worsened. Maintained status. - Skin: No new abnormalities noted on the belly. - Vulva: Appears normal on inspection. - Ears: Both ears feel normal temperature, no obvious signs of inflammation.  Assessment & Plan: 1. Left Eye Ulcer - Assessment: Stable descemetocele/corneal ulcer. No significant change since the last visit on 09/03/2026. - Treatment plan: Continue doxycycline for the remaining 4 days. A new script for doxycycline has been prepared. Dispensed a new course today. Continue Ocuflux/EDTA/viscotears as directed. - Follow-up recommendations: The owner has an appointment with Animal Eye Services scheduled for the end of March (brought forward from the second week of April). It was discussed that if the eye's condition deteriorates, an emergency appointment can be sought sooner. A recheck is scheduled for next Wednesday to reassess the eye.  2. Vaccinations - Procedures performed or scheduled: Vaccination deferred today due to being on antiviral medication (Ocuflux). Scheduled for next Wednesday, to be performed during the recheck appointment.  3. Skin/Allergies - Past medical history: Known sensitivity to grass. Currently receiving Cytopoint injections monthly. - Treatment plan: Continue monthly Cytopoint injections / beransa - apoquel as and when - Follow-up recommendations: Owner to monitor for any skin flare-ups, especially after recent lawn mowing in the vicinity.  Additional Notes: - Owner education provided about the diagnosis: Discussed that the eye ulcer is currently stable, which allows time for the scheduled ophthalmology appointment. Advised that if the owner is worried or wants peace of mind, they can contact the specialist for an earlier appointment. - Emergency care instructions: If the eye condition changes or worsens, the owner should seek an emergency appointment with the specialist. - Any specific concerns, questions, or preferences expressed by the owner and addressed during the visit: Owner expressed financial concerns regarding potential eye surgery and prefers to delay if medically appropriate, hoping to push any procedure closer to August when insurance resets. Confirmed that delaying is acceptable as long as the eye remains stable.Tgh w bupe for TM use duirng episodes of pain - seek AES appt sooner if any changes Consent has been given by the client to proceed with this treatment  -  Yes/No Plan: Scripts Needed - Yes or NoRevisit needed - Yes or No - ____ Days pleaseHistory-Update:Consent has been given by the client to proceed with this treatment  -  Yes/No Reason: Nurse: -vaccination -heartworm -worming -flea/ticks Exam: Lab: Assessment: Treatment: Plan:    Vital Signs    Weight: 8.2;