C09971844 / invoice 10000

History:- Presented for assessment of a dry, scaly, and itchy right ear, which has been noticed over the last couple of days.- There has been no recent swimming or grooming, with the last grooming session occurring in early December.- The owner notes a seasonal pattern to these ear issues, with previous infections occurring around this time of year.- Usually gets once case of OE per ear.- No other areas of pruritus- UTD flea/tick tmt.Physical Examination:- Demeanour: Bright, alert, and responsive.- Vital signs: Heart rate 136 bpm. Mucous membranes pink and moist with a CRT < 2 seconds.- Cardiovascular: No murmur or arrhythmia detected.- Ears: The right ear shows marked erythema and surface seborrhoea at the entrance to the vertical ear canal. There is mild stenosis on swabbing and a mild amount of light brown discharge. - The left ear appears clinically normal, but a mild amount of light brown discharge was present on the swab.- Skin: Otherwise NAD.Investigations/Laboratory:- Cytology (Right ear): Yeast 15/hpf.- Cytology (Left ear): Yeast 10/hpf.Assessment & Plan:1. Otitis Externa (Bilateral, Yeast)- Impression: Bilateral otitis externa with yeast overgrowth.- Treatment planned: Cleaned both ears. Commence Dermotic 0.3 mL in each ear, twice daily for one week.- The owner was instructed on how to administer the ear drops using the provided syringe, demonstrating the technique. - Discussed that if the frequency of infections increases to more than once per year, a maintenance medication (Elocon) could be considered during the allergy season to reduce inflammation and the likelihood of infection.Next Steps:- Recheck in one week to assess response to treatment.- If ear infections become more frequent (more than once per year), consider starting maintenance medication with Elocon.

History:- Presenting for ear infection: 2-3dd of pruritus associated with L ear & fould odour.- No recent swimming or grooming.- Previous ear infections: Approx once/year, unsure if seasonal.- No other areas of pruritus.Physical Examination:- Demeanour: anxious and timid but fine to handle- Vital signs: HR = PR = 146, MM pink, moist, CRT < 2 seconds- Auscultation: normal, no murmur or arrhythmia- BCS: 2.5/5- Ears: Right ear marked erythema and inflammation of internal tragus and entrance to ear canal. Mod lichenification & scaling of the internal pinna seconday to chronic inflammation. Moderate light yellow discharge present when swabbed, moderate hair matted at entrance to ear canal. Left ear NAD- Paws & skin: NADCytology: L ear - Malassezia ~10-12/hpfAssessment & Plan:1. Otitis externa - L ear (MD)- Impression: Malassezia otitis externa- Treatment: Dermotic twice daily for 7 days. Apply to ear canal and wipe residue onto inside of pinna.- Recommendations: Avoid grooming for 1 week to prevent water getting in ear.- Trimmed hair at ear entries to improve ventilationKey Takeaways:- Apply ear drops twice daily (morning and evening) for 7 days- Avoid grooming for 1 week- Return for recheck day 8

Reason:ItchyHistory: EDFU okNO V+ or D+tried antihistamine didnt workno new food or shampoosUTD flea controlExamine: HR =120mm=Pink CRT<2chest NADabdo NADteeth NADeyes. NADEars NADGeneralised errythemaall other NADAssessment: Allergic reactionPlan: reducing pred coursestart 1000 3/6/9 oil SID for underlying allergic skin