C09975587 / invoice 10000

Reason: Ear InfectionAppointment Notes: Booked Online: 25/02/2026 14:28:36 PMBooking Type: Skin, Ears, Eyes or LumpsBooking Notes: ear infectionOwner Name: Kristen ApokourastosOwner Email: kristenellese.apo@gmail.comOwner Mobile Number: 0406592727Pet Name: IsisPet Species: CatWeb BookingClient name: ApokourastosContact number: 0406592727Email address: kristenellese.apo@gmail.comPatient name: IsisNurse: AO--- 02/03/2026 15:28:49 ASH:Ear infection signs last week, dirty ears, scratching and shaking, used sonotix (caused no problems in the past for Iris), caused acute welts and scabbing on ears and swollen eye. Reacted suddenly when sonotix went into ear as if painful and did not want ears touched. Went to veca. Vet was in emergency and couldnt see Iris without long wait. After waiting one hour left as Iris was feeling better. Both ears still irritated now, worse in right side - eye and ear. Ear infection signs still present. Will not let owner touch ears now which is out of character. Irritation remained throughout the week, acute swelling and flare up reaction lasted less than 1hr, approx 20mins.Long repeated sneeze for 1 minute today. On telfast and doxy for allergic rhinitis. Eyes chronic swelling issue, worsens at times of stress. Had bruise near eye during episode. Continuing to toilet outside of tray - urine and faeces. Owner unsure what could be causing this. Heidi consent givenConsent for use of Heidi was obtained.History:Isis presented with ongoing ear infection following adverse reaction to Sonotic ear cleaner approximately one week agoOwner administered Sonotic ear cleaner as previously recommended - Isis immediately showed pain response, jumped off lap, violent head shaking and scratchingWithin 20 minutes developed blister-like lesions on ear tops, swelling, erythema, right eye swelling with bruisingEmergency vet visit - welts and swelling resolved by time of examination, nurse assessment only, advised to return if worsenedPersistent head shaking, scratching, scab formation and increased wax production since incidentRight eye remains irritated but not swollenIsis has chronic rhinitis with recurrent red, swollen eyesPreviously responsive to intermittent Telfast therapy but owner discontinued last week on advice from emergency clinicRecent weight loss success from 4.5kg down to 4.2kg on diet, now back to 4.5kg after slight food increaseRecent sneezing episode lasting approximately one minuteExamination:Mentation - BARBW - 4.5kgEars - bilateral otitis externa, right ear worse than left, moderate wax accumulation, erythema present, would not tolerate otoscope examination due to sensitivityEyes - bilateral conjunctivitis, right eye more affected, chronic changes consistent with rhinitisAssessment:Bilateral otitis externaChronic rhinitis with secondary conjunctivitisPossible allergic reaction to Sonotic ear cleaner vs pain response to ear pathologyOverweight Treatment:Ear examination and assessment performedClient Communication:Discussed possible causes of reaction to Sonotic - allergic reaction vs pain response if ulceration present in ear canalAdvised can restart Telfast therapy given history of good response and current flareDiscussed trial of Sonotic on cotton tip for external ear cleaning only to assess toleranceDiscussed dermatology referral for chronic ear infections and potential long-term management optionsAdvised to discontinue Sonotic immediately if reaction recursPlan:Ear medication course - start with one week, extend to 10 days if neededRestart Telfast 30mg (quarter of 120mg tablet) as previously prescribedTrial Sonotic on cotton tip for external ear cleaning onlyRecheck appointment after completion of ear medication courseConsider dermatology referral for chronic ear management if current treatment insufficientMonitor for any adverse reactions to Sonotic - discontinue permanently if reaction recursConsider prednisolone if antihistamine therapy insufficient for rhinitis control    Vital Signs    Weight: 4.5;