C09974122 / invoice 10000

Appointment Reason: Ear Issues, Appointment Notes: sore ears ?????SUMMARY* 6-year-old Rottweiler X presented with a one-week history of right ear pain, discharge, and recurrent ocular discharge, consistent with an allergic flare-up.* Diagnosis of right-sided otitis externa secondary to a mixed bacterial infection, confirmed via in-house cytology.* Plan is to treat the right ear with Otoflush and antibiotic drops, manage underlying allergies with Apoquel and immunology injections, and recheck in two weeks.HISTORY* One-week history of ear flapping and discharge (initially clear, now greyish).* Right ear is painful when touched.* Recurrent green ocular discharge noted.* Known history of atopy, recurrent ear and skin infections.* Currently on immunology injections from DFA (overdue) and Apoquel (dose recently reduced by owner, now giving 16mg PO only as required, not daily).* DFA allergy injections - still has 4 more injections to go before next repeat consult with DFA* Otherwise well; appetite and toileting normal.EXAMDemeanour: BAR; muzzled in consult as side-eying. Body condition score: 5/9Ambulation: normalEyes: Left eye non-erythematous. History of mucoid discharge but remarkable today.Skin: no unusual masses noted, normal skin tentHeart: heart and lungs auscultated. Normal rate, rhythm and soundsAbdomen: abdominal palpation normal, no pain or obvious masses identifiedLymph nodes: normal sizeRight ear: significant purulent exudate, mild pinna erythema. not reactive on palpation. Left ear: mild pinna erythema, not reactive, nil discharge. CYTOLOGYL ear NSFR ear rods & cocci both 4/5ASSESSMENT* Right Otitis Externa: Secondary to a mixed bacterial infection confirmed on cytology. Underlying cause is likely a flare-up of atopic skin disease.* Allergic Conjunctivitis: Ocular discharge likely secondary to allergic flare.PLAN* Clean BID with otoflush (both ears) for next 3 days* THEN in 3d (3/3/26), otoflush SID with easotic SID on R ear only for 5d* Stop easotic after 5d, only use otoflush EOD if required after 5d* vet recheck with AN in 10-14d or earlier if worsens/INI* o to ensure no meds in ears for at least 5d prior to recheck * continue apoquel 16mg PO SID for next 2 weeks until flare-up resolved* Immunology: Advised client to resume injections as scheduled.* Return sooner if clinical signs fail to improve or worsen.CLIENT COMMUNCIATION* Discussed diagnosis of a bacterial ear infection, likely secondary to an allergy flare-up.* Explained the importance of using the ear cleaner (Otoflush) to remove pus, allowing the antibiotic drops to penetrate effectively.* Detailed the treatment schedule for cleaning and medicating the ear.* Advised that managing the underlying allergies with Apoquel and immunology is key to preventing recurrence.* Instructed to monitor eyes and wipe discharge, but no specific medication is required at this stage as should likely resolve with flare-up resolution * Stressed the importance of the 2-week recheck to confirm resolution.02/03/2026 10:21:50 AM KJ:f/up text sent?????    Vital Signs    Weight: 35.2;