C09971657 / invoice 10000

SUBJECTIVE:scratching at R ear - ear infection late last year

DDUE all ok
o.s have had a small amount of difficulty getting medications in 
UTD with flea prevention , simparica trio
meds 

pred 10mg SID x 5dd then EOD - finished today
dermotic 1ml BID both ears, o.s have had a little bit of a struggle 

bathed a few days ago

OBJECTIVE:B+A

L ear - cytology +++yeast , very active budding yeast
R ear , + yeast- 

ASSESSMENT:Bilateral OE, yeast
shaking less but yeast otitis still very evident 

MEDICATION 
BNT bilaterally, repeat in 1 week after resmear

PLAN:
dermotic 1ml BID both ears
Recheck 7 days - discuss maintenance (apoquel? and ear cleaning after bathing)

SUBJECTIVE:scratching at R ear - ear infection late last year

OBJECTIVE:B+A
L ear - + waxy d/c, mild erythema, cyotl ++ yeast
R ear ++ waxy d/c, moderate erythema, +++ yeast

ASSESSMENT:Bilateral OE, yeast

PLAN:pred 10mg SID x 5dd then EOD
dermotic 1ml BID both ears
Recheck 10 days - discuss maintenance

HISTORY: Found grass seed in his chest, O was able to remove it. Also removed another 2 in other locations but they aren't swollen. They were all removed 36 hours ago. no current meds. 

EXAM:
BAR - doesn't tolerate exam well
Small scab on ventral chest near left axilla - can feel 1cm area of swelling underneath

ASSESSMENT: Grass seed abscess

PLAN:
Squeezed the scab and a small section of grass seed came out
Short course of abx to clear infection

MEDICATION:
Amoxyclav 3 days 250mg PO

COMMUNICATION:
Advised O that if swells up again will need surgery to open it up and search for more grass seed