C10027739 / invoice 10000

Reason: Lame On One Leg LJSubjective: Hesitant to jump and wobbly hind endObjective:  Moderate hind limb ataxia bilat with right > left mild placing deficit. No pain on spinal palpation and no Hx trauma. Heart and lungs OK on auscultation Assessment: proprioceptivve deficit with suspected spinal compression. Likely IVD protrusion DDX local spinal stroke or neoplasia. Coping OK ie can walk and urination and defecation OK. Present ~ 7 days but worse last few days Plan: start pred 5mg sid 5 days, 1/2 sid 5 days, 1/2 eod 10 days ( O has pred at home). O to ring with update 4 days    Vital Signs    Weight: 7.3;       

Reason: SL   R/v Ears   + Vacc  MDHad a groom on Thursday > still some gunkL>Rt otitis externa continuing. Will use a longer course of dermotic. Always had a bit of an itch > was worse at St Helens but not so much here > O hasnt noticed any skin erythema. HR slow chest clear MM pink CRT 1 sec Pulse strong LNs all ok NAD on abd palp. T 38.6 old age change eyes mild tartar UPM4s.    Vital Signs    Weight: 7.4;       

Reason: Ear Revisit - LNAppointment Notes: Saw Vet in St Helens for ear infectionSubjective: Objective:  seen with bilat otitis externa with yeast and rods. Given dermotic bid and r/v here. Ears clear with no wax and only debris on smear with no yeast or bacteria visible. No further Tx at this stage but gets otitis externa periodically and sometimes pruritis but no visible infection. Some foot licking and generalised scratching so possible allergic otitis / atopy. In for Vx 1 month so reassess ears then. Will look at novasone or cytopoint if recurrentAssessment:  Plan:    Vital Signs    Weight: 7.4;