C09979683 / invoice 10000

Reason: Ear Infection Appointment Notes: hsHistory: Presented for assessment of ear irritation, seen as significant head-shaking over thw past few days. Has also been licking his paws / forelegs for a similarly period of time. Has been otherwise well in the lead-up to this, EDDU and activity levels WNL's. Examine: Demeanour: BAR Behaviour: amenable, quietly tolerant MM's: P+M CRT: <2sAlimentary: little to nop calculus, no gingivitis Abdominal palpation: comfortable, no palpable masses or organomegaly Integument: Moderate dark patches of slightly thickened skin around his axillas, and mild dark brown discharge with minimal mild erythema between his forepaws Ears: mild to moderate LHS dry waxy discharge, mild on RHS. Similarly, mild to moderate erythema associated (LHS worst). LHS is dry but uncomfortable on palpationLaboratory: LHS ear swab cytology yielded moderate budding yeasts RHS yielded occassional budding yeasts. Treatment: Instilled 0.7mL of Dexamethasone ketoconazole into each ear and massaged into how lower ear canals. O has Malaseb at home. Discussed using it for baths for his paws and axillas - advised to dilute 1:10 in warm water and leave to soak in for 10 mins before rinsing it off Plan: Back for a recheck if his skin and ear irritations fail to improve or worsen O may come to collect more malaseb if they find the one they have at home has run out    Vital Signs    Weight: 7.5;