C09992318 / invoice 10000

 Have reminders been checked? Y/NHas the owner been advised of this? Y/NFirst Clinic Signs: couple of weeks scratching and shaking head (consult 4/2/26) - revisit today Diagnosis/Suspected: poss underlying allergy - resolved otitis externa Summary/Suspected Cause: poss underlying allergy - resolved otitis externa Any other conditions being treated/known health concerns(if any): lump on tail Treatment/Plan: epiotic for once weekly ear cleaningHX:Reminders checked: Y - NG r/v ears and discuss lump on tailDaughter brought mum in for clarification of some details- daughter very concerned he'll need to lose the tail Preventatives: NGSExam:OMMs pink CRT 1 secG2 DCChest: no obvious murmurs/arrhythmias, lung fields clearAbdomen: MSN:Skin/ears/eyes/coat:- 7mm mass underside of tail, approx midway - ears look great, small amt debris, TMs nad-- cytology: occas mal only - 0-1+ hpf both earsTx/Plan:rec dental and excision of mass; option to FNA today but may aggravate mass (best to do while under GA for surgery OR sending off for histopath)discussed GAP fee of 850explained worse case scenario will require freq bandage changes if needing to heal by second intensionRec weekly ear cleaning with epiotic

2.5mls placed into both ears

Have reminders been checked? Y/NHas the owner been advised of this? Y/NGapOnly claim Insurance SummaryFirst Clinic Signs: couple of weeks scratching and shaking head Diagnosis/Suspected: allergy Summary/Suspected Cause: allergy Any other conditions being treated/known health concerns(if any): lump on tail Treatment/Plan: ekt, pred, ear flush, consider biopsy for lump Couple of weeks of rubbing at ears and scracthing in general. Does lick paws but not too red. EDDU normal.Not on any meds at home. Lump on tail since a puppy and was samll abut gotten bigger recently. Doesn't worry her. mm pink, CRT < 2 sec, teeth garde 2 but mising PMs and no Hx of dental? Discussed could do dentala nd x-ray area if needed. HR WNL, chest clear, NAD adbo palp,LS WNL.Both ear canals large amount yeast buds, can't see to ear drums. Cutabneous mass underside of tail approx 7mm diameter. Discussed FNA but O keen to remove as growing so will get dental and biopsy at same time. Have discussed with SB - happy to do both at same time. Have warned O that if can't get closure may need to be left as open wound and dressingsPLAN:Flush both canals2ml EKT both ears, reepat in 1 weekRepeat cytology 2 weeks after final EKT dose.Short course pred. Send estimate for denatl and lump removal.