C10027501 / invoice 10000

Reason: Ear And Pred RVAppointment Notes: Overdue reminders bhPrevious known history: BIOP since 18mo, hx of abuse. Chronic recurrent skin problems. Current Medications & Dose: Nil History (From Owner): Appetite: improved on pred but back to pre pred levels, very fussy. Diet: Cooked meat, woolies mince, My Dog chicken, sausageVomiting?: Nil Drinking: NAD Energy Levels: NAD Urine: NAD Faeces: NAD  Vaccination Status:Parasite control:Microchip up to date?How have they been since last visit?PU/PD has resolved with pred being discontinued. Lost 800g Examine: Behavioural: NervousMentation: BAR Gait: weak HLs bilaterally but significantly improved from previously.  Physical Exam (See Vital Signs): MM Moistness: Moist, WNL Skin Turgor: Nil skin tent Eyes: Bilateral senile nuclear sclerosisEars: Cerumen discharge from both ears,. Cyology: L ear cocci ++, R ear negative for infectious elements. Nose: Hyperkeratosis of nasal planum. Mouth: Multifocal gingival growths, suspected epuli Teeth: Mild - moderate diffuse tartar, mild gingivitisLymph nodes: Nil peripheral lymphadenopathy Thoracic auscultation: No murmurs or arrhythmias, lungs clear Pulse rate/quality: Strong, synchronous Abdominal palpation: Tense, NAD Skin: Minimal inflammation. Musculoskeletal: Mild RHL lameness, full MSK exam not performed. Anal Sacs: Not assessed Reproductive: Desexed Assessment:Unilateral otitis externa - L ear Appetite waxing and waning. - improved with pred.Unintentional weightloss Treatment (See invoice items and client information):To commence pmp BID into L ear - already has supply at home. To continue pred 2.5mg PO SID ongoing. Otoflush SID into L ear, weekly into R. Plan (See medication labels, reminders and instructions):RV 14d.    Vital Signs    Weight: 24.5;