C09974592 / invoice 10000

Species:CANINE
Breed:Border Collie
Age (years):1
Diagnosis or signs:See notes
Consult notes
Right ear infection. 

Hx:  (O noticed ear was dirty yesterday and brought in today)

HR: 120
RR: Panting
Temp: 38.7
MM pale pink, CRT <1.5s.

Ears:
Sedation was required:
1ml Methadone/0.5ml Domitor SC

Examination: 
Left Ear: clean
Pinna: normal 
Ear Canal: clean 
Tympanic membrane: intact
Smear: NIL 

Right Ear:- lots of black discharge 
Pinna: (Erythematous and inflammed)
Ear Canal: (stenotic/erythematous/cerumen/painful)
Tympanic membrane: Not in tact 
Smear: Cocci and malassezia 


DDx:
Right ear infection 

Tx:
0.5ml Dexapent 
2ml Enrotil SC
2ml Amoxicillin SC
2ml Cerenia SC
2ml Metomide SC


TGH:
Amoxyclav 500mg tabs x 30 -> 1 tab BID for 2 weeks 
Enro 150mg tabs x 14 -> 1 tab SID for 2 weeks 

Plan:
Ear culture sent for C&S

Animal clinical history (3 most recent)

2026-03-02T00:00:00Z 13:30:00
Right ear infection. 

Hx:  (O noticed ear was dirty yesterday and brought in today)

HR: 120
RR: Panting
Temp: 38.7
MM pale pink, CRT <1.5s.

Ears:
Sedation was required:
1ml Methadone/0.5ml Domitor SC

Examination: 
Left Ear: clean
Pinna: normal 
Ear Canal: clean 
Tympanic membrane: intact
Smear: NIL 

Right Ear:- lots of black discharge 
Pinna: (Erythematous and inflammed)
Ear Canal: (stenotic/erythematous/cerumen/painful)
Tympanic membrane: Not in tact 
Smear: Cocci and malassezia 


DDx:
Right ear infection 

Tx:
0.5ml Dexapent 
2ml Enrotil SC
2ml Amoxicillin SC
2ml Cerenia SC
2ml Metomide SC


TGH:
Amoxyclav 500mg tabs x 30 -> 1 tab BID for 2 weeks 
Enro 150mg tabs x 14 -> 1 tab SID for 2 weeks 

Plan:
Ear culture sent for C&S

Previous claim history (2)

DateClaim #Diagnosis
2026-01-25C09807441WOUND - LACERATION
2026-01-23C09802471LACERATION

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_consultation145.002026-03-02
20000tstarc_procedure_fee_-_ear_flush145.002026-03-02
30000tstarc_sedation_for_procedure81.002026-03-02
40000tstarc_opioids_-_methadone52.752026-03-02
50000tstarc_anaesthesia_-_monitoring74.002026-03-02
60000tstarc_anti-nausea_medication85.002026-03-02
70000tstarc_anti-nausea_medication109.452026-03-02
80000tstarc_antibiotics_-_enrofloxacin77.502026-03-02
90000tstarc_antibiotics_-_amoxicillin72.352026-03-02
100000tstarc_antibiotics_-_amoxicillin_and_clavulanic_acid147.402026-03-02
110000tstarc_antibiotics_-_enrofloxacin185.402026-03-02
120000tstarc_diagnostic_test_-_culture_and_sensitivity199.002026-03-02

UPM+

  • DG01185OTITIS EXTERNADSTP_otitis_externa

Variant (sleepy_king)

OTITIS EXTERNA
DSTP_otitis_externa
Conf: 0.810
Threshold: 0.07
Above:
Correct?