C10003806 / invoice 10000

Reason: EarsAppointment Notes: Overdue remindersHistory:Has been good until last week, when started topant and other dog licks her ears and odour change to Deborah.Cleaned with Sonotix, not much discharge, ear now more inflamed.Deborah feels had ruptured TM 19/12/2026 when had blood on bed.Not been to river.Started human bikkies Tiny Teddies few weeks ago - Deborah wonders if has allergy. Will send list of ingredientsUsual food fresh cooked chicken or lamb (no beef) 60%, Applaws supermarket dry food 40%, occ raw egg, pig ears, dehydrated chicken treats, cheese odd yoghurt.No access to known toxins.No flea/tick products, personal anxiety. Only HW and GI worming.Pred 20 mg po last 2 mornkngs, paraetmaol both days 500 mg Examine:BAR but unusually restless in cons according to Deborah.11.45  T 39.0 - high normalChest nad apart from tachypnoeaSuperficial LNs Eyes mild conjunctival injection but no cherry eye  at present.Ears both sl inflamed but no matter in ears. R ear canals wide, sl restriction L Assessment:Likely imminent OE.Good use of steroids.Treatment:Decline flea/tick products.Milbemax monthly, both dgs.Change to topical mometasone 1.5 ml both ears 5 days, stop 2d then phone progress report. - demonstrated    Vital Signs