C09984912 / invoice 10000

Species:CANINE
Breed:Pomeranian
Age (years):6
Diagnosis or signs:Check Ears
Consult notes
04/03/2026 History 
Shaking head lots yesterday - unsure if ears are bothering him?
Has had one infection before a year ago in R ear - resolved with ear drops
EDUF normally otherwise
BIOP since 2023 - one episode of back pain, resolved with rest and pain-relief. 
Also reportedly had pancreatitis prior to adoption 

Physical exam
BAR, a little anxious but good when going slow. Did try to bite with otoscope though!
MM Pink, moist
CRT <2s
HR 96
Cardiac ausc NAD
RR panting
Lung sounds Clear
Abdo palp Tense, likely stress-related
Pulses: normal, = 
temp not taken
LNs: WNL
EENO Dental disease 3/4, could not look into mouth too much as mouth shy. L ear NAD from afar, R ear canal has some yellow brown discharge, but only slightly erythemic. Would not tolerate otoscopic exam
Skin NAD
MSK & Neuro: Ambulatory, not fully assessed

Cytology of ears: 
L ear NAD
R ear ++ cocci. 

Problem list: 
1. R otitis externa
Ddx: allergies (atopy, contact, food, etc) vs FB vs parasites vs other 
Client comm: Discussed cycle of allergies. Given frequency of ear infection at this stage is not too frequent (1x a year), can consider treating as needed, but if more frequent need to trial something to control itch before secondary infection happens. 

2. Dental disease 

Plan: Trial keto/dex/enro drops 0.3ml into R ear BID x7d
RV INI 
O to consider dental soon - has some personal issues to deal with first 

Animal clinical history (3 most recent)

2026-03-04T00:00:00Z 10:09:15
History 
Shaking head lots yesterday - unsure if ears are bothering him?
Has had one infection before a year ago in R ear - resolved with ear drops
EDUF normally otherwise
BIOP since 2023 - one episode of back pain, resolved with rest and pain-relief. 
Also reportedly had pancreatitis prior to adoption 

Physical exam
BAR, a little anxious but good when going slow. Did try to bite with otoscope though!
MM Pink, moist
CRT <2s
HR 96
Cardiac ausc NAD
RR panting
Lung sounds Clear
Abdo palp Tense, likely stress-related
Pulses: normal, = 
temp not taken
LNs: WNL
EENO Dental disease 3/4, could not look into mouth too much as mouth shy. L ear NAD from afar, R ear canal has some yellow brown discharge, but only slightly erythemic. Would not tolerate otoscopic exam
Skin NAD
MSK & Neuro: Ambulatory, not fully assessed

Cytology of ears: 
L ear NAD
R ear ++ cocci. 

Problem list: 
1. R otitis externa
Ddx: allergies (atopy, contact, food, etc) vs FB vs parasites vs other 
Client comm: Discussed cycle of allergies. Given frequency of ear infection at this stage is not too frequent (1x a year), can consider treating as needed, but if more frequent need to trial something to control itch before secondary infection happens. 

2. Dental disease 

Plan: Trial keto/dex/enro drops 0.3ml into R ear BID x7d
RV INI 
O to consider dental soon - has some personal issues to deal with first 

Previous claim history

DateClaim #Diagnosis
No prior claims.

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_consultation110.202026-03-04
20000tstarc_diagnostic_test_-_cytology60.502026-03-04
30000tstarc_ear_medication_-_antibacterial_and_anti-fungal116.392026-03-04

UPM+

  • DG01185OTITIS EXTERNADSTP_otitis_externa

Variant (sleepy_king)

OTITIS EXTERNA
DSTP_otitis_externa
Conf: 0.880
Threshold: 0.07
Above:
Correct?