C09983177 / invoice 10000

Reason: Ear Has Blood Coming Out & GrossAppointment Notes: Special payment terms exist, Overdue remindersHistory:Kevin presented today with an irritated left ear. There is discharge and some crusting at the pinna. Kevin had a dental procedure last week and has some meloxicam for the associated pain/inflammation. Kevin also has cyclosporine to help with skin condition.Focussed exam:Swabs taken from both ear canals. The right ear had some debris, but no microbes. The left ear has a sea of neutrophils, moderate cocci in pairs (likely staph), other populations of cocci bacteria, moderate short rods and mild malassezia yeast spores.Assessment:Left ear otitis externa - mixed populations of bacteria and yeast.Plan:Kevin is tricky to medicate. Give Mometamax Ultra in the left ear.Recheck next month.Treatment:Mometamax ultra administered into the left ear canal. Warned owner that ideally this medication works better following an ear clean/flush under heavy sedation or GA.--- 02/03/2026 08:21:08 KAB:I saw "Kevin" de Wit on Friday afternoon and gave Mometamax ultra into the left ear canal. But, I've incorrectly charged for two doses instead of one. Could you please organise a credit/refund. Sorry. PB.--- 02/03/2026 09:31:21 KAB: called and advised owner of this, will leave account in credit    Vital Signs    Weight: 24.4;