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Paddington Vets
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Appointment: Right Ear Pain & Paw Licking for Bella
Message
IN PROGRESS
Bella
Dog • Cocker Spaniel • 6 yr • F/S • 13 kg
WM Dr William Meter
+447887186524
disasterwill@connect.com
-€45.00
Details
Animal Details
Medical Highlights
History
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Diagnostic Tests
Plan & Invoicing
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No client booking notes
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No internal booking notes
Animal Details (ID: 156)
Name
Bella
Age
6 Years
Registered At
12 May 2025
Internal Animal Notes
Prefers women
Is a rescue so go slow
Species
Dog
Date of Birth
10 Mar 2020
Primary Store
Carlton Pet Daycare & Grooming
Breed
Cocker Spaniel
Deceased
No
Sex
Female
Microchip Number
939644702354930
Clinical Notes
S – Subjective
Owner reports 4 days of right-ear head-shaking and scratching, worse over the last 48h. Brown, malodorous discharge since yesterday. Licking both front paws ~1 week. No vestibular signs. Eating, drinking and toileting normal. On Apoquel 5.4 mg SID, good compliance.
O – Objective
- T 38.6°C, HR 100 bpm, MM pink, CRT <2s. BCS 5/9, 13.2 kg (stable)
- Right ear: erythematous, mildly stenotic, moderate dark-brown ceruminous–purulent discharge, malodorous. Painful on palpation. TM not visualised
- Left ear: mild erythema, scant cerumen, non-painful. TM intact
- Front paws: mild interdigital erythema and salivary staining, no pustules
- Cytology (R ear): numerous cocci + neutrophils, intracellular bacteria, Malassezia 2–5/hpf
A – Assessment
- Right otitis externa (cocci + Malassezia), secondary to underlying CAD
- Atopic dermatitis flare, mild, with early front-paw pododermatitis
- Left ear low-grade, no active infection
P – Plan
- Right ear flushed and cleaned in clinic; debris removed
- Osurnia applied today; owner to apply 2nd dose on day 7
- Continue Apoquel 5.4 mg SID. No home cleaning while medicated, keep ear dry
- Recheck right ear in 10–14 days, repeat cytology. Return sooner if pain, head tilt or balance change
AI Animal Summary
AI Assistant
AI Assistant
Conditions
Medical & Surgical History
Canine atopic dermatitis (CAD) – diagnosed Mar 2023, ongoing
- Bilateral pruritus, recurrent pododermatitis and otitis. Managed on oclacitinib with periodic flares (seasonal worsening spring/summer). Good control when compliant. CAD review
- Diagnosis by exclusion: negative diet trial Jan–Mar 2023, ectoparasites ruled out, response to anti-inflammatory therapy. CAD workup
Recurrent otitis externa (bilateral) – first recorded Jun 2023
- Right ear: ceruminous discharge, erythema. Cytology showed Malassezia and cocci. Treated topically, resolved at recheck. Otitis Jul 2025
- Both ears mildly stenotic, low-grade erythema at annual. No active infection. Owner cleaning weekly. Annual ear check Apr 2025
- Left ear cleaned under sedation due to pain and stenosis. Marked Malassezia overgrowth. Otitis Sep 2024
Anal sac impaction – recurrent
- Both sacs expressed, non-infected, thick brown content. Owner advised on fiber. Recurs every 3–4 months. AG express Feb 2025
Ovariohysterectomy – Aug 2020
- Routine spay, no complications. Spay
Drug History
Active Prescriptions
- Apoquel (oclacitinib) 5.4 mg, 1 tablet PO SID, maintenance. Last dispensed 60 tablets, May 2026
- Piriton (chlorphenamine) 4 mg, PRN for flares, owner-managed
Immunisation Status
- DHP, Apr 2026 (due Apr 2029)
- Leptospirosis L4, Apr 2026 (due Apr 2027)
- Kennel cough intranasal, Apr 2026 (due Apr 2027)
Parasite Control
- NexGard Spectra, last given May 2026. Owner on monthly reminder
- Roundworm/lungworm cover via NexGard Spectra confirmed
Documents
Referral Letters
No referral letters found
Lab & Diagnostic Reports
- Ear cytology, Jul 2025 (in-house, no external report attached)
Ask Jerry anything to do with Bella
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Bella · Cocker Spaniel · listening…
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AI Billing Suggestions
Add Ear flush (service) and Osurnia otic gel, single tube to the invoice
AI Medical Suggestions
Diagnosis to add: Right otitis externa
Treatment to add: Osurnia, dose 1 applied in clinic 25 Jun 2026, dose 2 due day 7 (home)
AI Task Creation
Create a task for AI receptionist to follow up with the owner after 7 days
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Paddington Vets
Store
Conversations New
Open 3Closed 2All
All assignees
OPEN 3
Priya Nair#C-104308:41
Post-op check: Simba
Quick question, is it okay to take his cone off…
Open since 2dHighAL
Valentina Rojas#C-105120h
Re: food reorder for Luna
I might need to move the appointment, are y…
Open since 20h
Amara Okafor#C-10664h
Vaccinations due for Bella
Thank you! See you then, that's a relief…
Open since 4hMediumVT
Wei Chen #C-1029 3 members
Lab results query
Low
Aga
Closed
Aga
Closed
#C-1029 · Lab results query · Opened 8 May · Closed 13 May 2026
8 May 2026
Wei ChenWhatsAppAre the blood results back yet?
11:00
WhatsAppAga (Nurse)
Yes, everything is within normal range. No action needed on your side.
11:40
Wei ChenWhatsAppThat's a relief, thank you so much!
11:42
This conversation is closed
Closed 13 May 2026 · Reopen to send messages. Only the most recent conversation can be reopened.
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Dog - Dental
Dogs aged 7+ with no dental appointment or billed dental item in the last 12 months
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9:41
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Paddington Vets
Hi [Name], it's [Practice] 🐾
June is Pet Dental Month. Bad breath, yellow-brown teeth or sore gums are easy to miss and affect most dogs over 7.
We've got dental check appointments open this month.
You can book a time here, or send us a photo of [Dog]'s teeth if you want us to take a look first.
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OPEN 4
Sophie Bramwell#C-1071now
Appointment enquiry
Do you think Ozzie needs an appointment?
Open since nowMediumAL
Priya Nair#C-104308:41
Post-op check: Simba
Quick question, is it okay to take his cone off…
Open since 2dHighAL
Valentina Rojas#C-105120h
Re: food reorder for Luna
I might need to move the appointment, are y…
Open since 20h
Sophie Bramwell
Appointment enquiry
#C-1071 · Appointment enquiry · Opened just now
Today
Paddington VetsWhatsApp
Sent Dental Campaign
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09:05
Sophie BramwellWhatsAppDo you think Ozzie needs an appointment?
09:12
Dr Emma HartWhatsApp
Hi Sophie, thanks for sending the photo of Ozzie. There's tartar building up on those back teeth, so yes, worth booking him in for a dental check so we can take a proper look.
09:14
Dr Emma HartWhatsApp
Book an appointmentcalendar.paddingtonvets.co.uk
https://calendar.paddingtonvets.co.uk
09:15
+
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Type a message…
Hi Sophie, thanks for sending the photo of Ozzie. There's tartar
building up on those back teeth, so yes, worth booking him in for a
dental check so we can take a proper look.
Reach your clients where they are.
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Assign conversation
Re: Appointment enquiry — Ozzie
Add more details…Responded to dental campaign. Review photo, assess for dental checkup and reply to Sophie
Priority
Medium
Veterinarian
Assignee
Dr Emma Hart
Dr Emma Hart
Dr James Nickson
Dr Emma Hart
Dr Emma Hart Dr James Nickson
Due
dd / mm / yyyy
— / — / —
Sophie Bramwell
Ozzie
Sophie Bramwell
Ozzie
This task is linked to conversation #C-1071
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Invoice · Bella · Consultation
Consultation, 15 min£42.00
Annual booster (DHP + L4)£48.00
Kennel cough vaccine£26.00
AIFlea treatment+ £18.00Add
AIDental chew+ £9.50Add
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What has Bella been vaccinated against this year?
Bella has had DHP (Jun 2025) and Leptospirosis L4 (Jun 2025). Next booster due Jun 2026.
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🐾Paddington Vets Clinic
Dental Season!
A little extra care for those teeth and gums goes a long way.
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