C10024330 / invoice 10000

Hx: going well at home - has BC collapse syndrome - O concerned nexgard may be contributing to this.Never had any vacc reactions - has prev had annual vaccs in melb.EDFU WNLs - good mobility, no other health concernsEx:MMC P CRT 1sEENo WNLs - swbs down canals NADPLNs WNLSthoracic ausc nadabdo palp nadinteg nadUG nadMSK nadnobivac D5 given SQ.Discussed small amount of dogs may get neurological side effects from newer gen flea tx but very rare and usually symptoms are more overt. BUT if wanting to try another product then revolution or advocate may be a good option with similar parasite spectrum. Discussed tapeworms as none of these products cover these - O does feed some raw offal - recommend cooking first to reduce parasite and bacterial risk.

recheck of ears- had them cleaned in Aug- both canals look great, no rednmess, some waxy debris- use epi otic.also clipped nails and exp Ags.discussed dental care.

History -Had been going well but there has been some shaking at times.O wanting it checked out as was difficult to tell last time.Physical exam -L ear - Mild brown discharge in canal, TM looks intact.Cytology - lots of gunk but some malassezia + and cocci +R ear - Same as above but less discharge.Cytology - Rare malassezia and cocci.Assessment -Mild otitis externaPlan -Cleaned out ears with Epi-Otic SISCan be a bit difficult to medicate so elect for SID tx.Easotic 1 pump into both ears SID for 5 days.EpiOtic SID clean fortnightly on going.