C09980034 / invoice 10000

Sore again with R ear ~ 1 week, maybe a bit off in self too.
Not able to get in here sooner and had some Dermotic left, so O has used a bit of this, last dose last night.

PEx QAR, good boy, taking treats gently.
Mms pink, moist, crt 1s.  Dental grade 2 upper carnassials, rest of teeth lovely.
Thoracic ausc/abdo palp NAD.

L ear mild inflam, gloopy yellow discharge.
R ear bit more inflamed, brown liquidy discharge.  
Both ears no obv FB and TMs appear intact.

Cytology R ear may be limited with recent Dermotic use.  Could do just L ear.  Other option to Tx presumptively, and then cytology at end of Tx course.  Discuss Dermotic + Otoflush vs EKT.  Elect Dermotic + Otoflush.
Tx 10ds, re-check ~2ds later.

NB O will bring back for rpt bloods for liver enzymes (see Hx) early next year, currently dealing with v expensive horse vet bill.

Painful in one ear, unsure which one. 

Very good boy. Quiet. 
Right ear- full of dark discharge, cannot see TM. Cytology: +++cocci, + malassezia, some degenerate neutrophils
Left ear- small amount of brown discharge. TM ok. Cytology: clear

Right ear otitis externa

Dermotic R ear BID 14 days. O has some at home, but if this bottle runs out ok to pick up more 
R/v 14 days. 
advise using Otoflush once a week

Has been a bit hunched/NQR for about a week.  Not able to get in here, took to other Warrandyte clinic ~5ds - Tx for ear infection Dermotic 0.7mls both ears Tx.
On a milk thistle supplement.
Squats to urinate (normal for him).  Will only urinate when on walks, will not urinate in yard.
No changes noted to urination behaviour.
Appetite/drinking normal, no V+/D+.

PEx BAR, good boy, keen on treats.
Mms pink, moist, crt 1s, teeth mod tartar upper carnassials, rest good.
NAD neck/back palp.
Thoracic ausc NAD.
Abdo palp NAD.
LNs wnls.
T 38.5oC.
L ear NAD (hard to get to TM).  R ear v small amount wax, TM intact, no FB noted.

Ddx behavioural, related to ear infection (resolving), UTI, other.

Monitor for now and finish ear meds as directed.  Consider urine sample to check for any urinary cause.