C10002896 / invoice 10000

Reason: Recheck EarsHistory: Millie is presenting today for assessment of irritated ears. Millie has a history of chronic ear infection with Pseudomonas. The infection was confirmed resolved; however, over the last week Millie has started pawing at her left ear again.Millie will swim in the pool, she had a swim today also. The owners will be travelling to NSW tomorrow to adopt a dog. They will be in the bush- the owner has purchased a Seresto collar for tick protection and she would like me to put it on Millie todayExamination: Otoscopic examination: Left ear contained clear serous material and a black, waxy plug. There is very mild inflammation. Right ear also contained clear serous material with very little brown waxy materialLaboratory: Ear cytology- Left ear: baccili >100/hpf and scant malasezzia; Right ear: 20-50/hpf baccili. Assessment: Bilateral mixed otitis externa. Suspect Pseudomonas due to characteristic of bacteriaTreatment: Dermotic 1ml into both ears BIDEasotic 1ml into both ears BID, 15 minutes BEFORE DermoticConsent has been given by the client to proceed with this treatment  -  Yes Plan:Recheck ears in 12 days (going for a swim in a dam in 2 days and recommend 10 days treatment post swim). Explained Easotic contained EDTA which is can help make Pseudomonas more susceptible to the antibiotics. Recommend to use a new syringe for every treatment for each ear to try avoid any possible contamination, in case there has been in the past; thus causing the reinfection. I suspect there is a biofilm; hence why the unremarkable cytology last week. The EDTA will help combat the biofilm. If there is no resolution to the ear infection; recommend seeking Dermatologist opinionPlaced Seresto collar on MillieDiscussed possibly using ear plugs for Millie, both myself and Philippa will do research into this. Explained water won't cause infection but it will perpetuate it.--- 05/03/2026 09:18:48 AM HEK:Examinations - Resolved -    Vital Signs    Weight: 24.1;