C09975067 / invoice 10000

Dex Flam ear drops Administer ear drops three times a week to both ears for at least one month.

History:- Recheck for ears.Physical Examination:- Eyes appear normal.- Otoscopic examination: both ears very narrow minimal discharge - Right ear contains some yeast cytology. Left ear is clear(was one treated last consult).Assessment & Plan:1. Otitis Externa (Yeast)- Impression: Mild yeast otitis in the right ear.- Treatment planned: Administered Cytopoint 10mg subcutaneous injection. Dispensed preventative ear drops (flamazine/dex) - owner can get more whenever she needs - Clinician's recommendations, education and counselling for issue 1.: Advised to continue using the preventative drops for at least one month, three times a week in both ears. The drops should be kept in the fridge. Discussed potentially weaning down to once or twice a week for long-term maintenance. No further recheck is necessary unless concerns arise. More drops can be collected from the clinic as needed.Key Takeaways:- Administer ear drops three times a week to both ears for at least one month.- Store ear drops in the refrigerator.Next Steps:- Continue ear drop administration as directed.- Monitor for any signs of recurrence or worsening of ear issues.- Contact the clinic if more medication is required or if there are any concerns.

History:- Recurrent L ear (OE), last episode December 2024.- Stopped maintenance ear drops couple of months ago as O thought condition was stable. Also compliance is an issue - Daisy doesn't tolerate ear handling well.- Owner reports current episode not as severe as previous episodes - has just noticed some ear redness & occ shaking.- Cytopoint last given 4th June - responds well.Physical Examination:- BAR - sweet girl- Heart rate: 140 bpm- Mucous membranes: pink, moist- CRT: <2 seconds- Auscultation: normal, no murmur or arrhythmia- Abdomen: soft and comfortable- Right ear: NAD- Left ear: mild erythema of internal pinna, tragus, and entrance to ear canal, mildly stenosed vertical ear canal, uncomfortable on swabbing, very mild light brown dry discharge in vertical ear canal.- R ear NADInvestigations/Laboratory:- Ear cytology: 1 yeast per 10 high power field views, no bacteria, occasional inflammatory cellsAssessment & Plan:1. Left ear inflammation with mild malassezia (possibly developing infection).- Mild inflammatory condition rather than active infection currently.- Ear cleaned with Otoflush.- Netra one dose instilled for anti-inflammatory effect and malassezia coverage- Review in 2 weeks- Keep ears dry- If clear at recheck, consider Elicon q2 weeks as maintenance (Q2w) due to compliance issues with previous maintenance drops.Next Steps:- Review appointment in 2 weeks- Consider Elicon maintenance protocol if ear clear at recheck