C09973205 / invoice 10000

Vet: Nurse: DTHistory:EDUD normally no v d or cDiet: back to original food, meaty bite sometime kibble.Medications: noVaccination: UTDParasite preventatives: UTDBehaviour: relaxRecheck appointment for a bilateral ear infection. The owner reports Lolly scratched at her ears for the first one to two days after the last visit, but has not since. The owner has been able to administer the ear medication and cleaner at home.EDUD normally no v d or cDiet: Returned to her original food after a previous reaction, with no issues since.Behaviour: Plays outside frequently.Examination:BARCardiovascular: HR 88 bpm, no murmur, or arrhythmia, femoral pulses=HRMM pink, CRT <2Respiratory: WNL, normal respiratory noises, no nasal dischargeOral: NSF, G1 dental no gingivitis or recessionEyes: clean and clearEars: Ears are very dirty bilaterally, and the ear canals cannot be visualised.Integument: normal skin and haircoatT: 38.24BCS: 5/9Assessment:Ear sample : in VueLeft ear : numerous yeast seen (3-4+) no cocci and rod were seenRight ear : numerous yeast seen (3-4+) no cocci and rod were seenAssessment & Plan:1. Bilateral otitis externa (yeast)- Ear cytology revealed 3-4+ yeast in both ears, which has worsened since the last visit.- An ear flush under sedation is recommended to address the underlying infection and check for a foreign body.- A long-acting ear medication (Metamax Ultra) will be placed following the flush.- A maintenance plan will be established, including weekly ear cleaning with an antibiotic, anti-inflammatory lotion (Alcon).2. Suspected underlying allergies- A strong link between ear infections and allergies in dogs was discussed.- A hypoallergenic food trial is the preferred diagnostic approach over allergy medications.3. Ear Flush Procedure- An ear flush under sedation is planned.- An estimate was provided for the procedure.- The procedure includes the ear flush and administration of Metamax Ultra.- Pre-anaesthetic bloods are not required as they were performed in January 2026.- The owner will contact the clinic to book the procedure.

Vet: NW Nurse: LMcHistory:EDUD normally no v d or cDiet: meaty bites and kibble (changed kibble to maybe Natures something which was regular diet previously)Medications: none (finished easotic 3 days ago, O did it for 6 days, been cleaning ears BID with epiotic sis, just didn't clean it last nightVaccination: UTDParasite preventatives: UTD, not sure whichBehaviour: friendlyHere to recheck ears - no signs not scratching or rubbing ears or shaking headExamination:BARCardiovascular: HR 88bpm, no murmur, or arrhythmia, femoral pulses=HRMM pink, CRT <2Respiratory: WNL, normal respiratory noises, no nasal dischargeEars: both ears very itchy when swabs taken and dark brown discharge on both, yelped during otoscopic exam R ear however can visualise TM, L ear lots of discharge however unable to visualise TMEar cytology (in-vue): R cocci +, L yeast +T: not takenBCS: /9Assessment:Subclinical OE persistingEar cytology (in-vue): R cocci +, L yeast +Plan:1. Clean ears weekly for a month with epiotic sis, then recheck in 4 weeks2. If infection improves in 1 month then go to monthly cleans3. Continue on regular diet that was on prior to ear infection. O changed diet which coincided with first episode of ear infection

Vet: Nurse:History:EDUD normally no v d or cDiet:Medications: noneVaccination:Parasite preventatives:Behaviour:O thought ears were better, can't remember when last meds or when last cleaned earsExamination:BARL ear - malodourousR ear - no smellCannot check ears with otoscope due to discomfortCytology:L ear - Malassezia ++++R ear - Waxy debris, no evidence of infectionAssessment:Treatment:Plan:1.2.3.