C10004363 / invoice 10000

Reason: Sore EarsConsult with => Dave History: BIOP since 6 months old.R ear  => lump medial aspect of pinnae - noticed a month or so ago - is growing. L ear => chronic inflammation as well.Not currently on any meds - no Hx of adverse med events EDUF DIET => dry commercial - salmon - local company. BID.Objective:-Sore/  Inflamed ear- R & L RIGHT EAR => large lump inner aspect of pinnae (unlikely to be able to resect without pinnae amptuation as well - consider biopsy)LEFT EAR => chronically swollen and reduced diameter of canal (as mentioned last time here) Discharge description - dark, creamyVisualisation of ear drum - NLaboratory: Cytology - Yeast ++ cocci ++++ - bilterally Assessment: Otitis Externa primary Plan:Oral Preds 0.5-1mg/kg daily) Book for next week to have GA - ear flush - remove / biopsy lump R ear pinnaeDidnt touch on bilateral lateral wall resections yet - primary concern for now is the fast growing lump on the R ear--- 03/03/2026 17:16:05 KH:Estimate done- surgery to attmept to remove- may only end up biopsying mass and hsito path and ear flush _ eaar inhouse cytology    Vital Signs    Weight: 22;       

Reason: Recheck EarsAppointment Notes: bdConsult with: DaveHsitory: O continued using AurizonAslo cont oticlean- only missed a few daysOtto much more comfortableExamination:R ear- pinna flat, entry to canal more openDischarge ++, minmal inflam L ear- cauliflowered in a major way- canal entry not super open ++ discharge- minimal inflamBoth ears comfortable PLan:Oticlean using a syringe and 1-1.5msl, one day, then clean with swabs and cotton tips the nextAlternate Recommended using epiotic 3-4 x weeklyRealises chronic, management is the key and may have flareupsWill be almost impossible to keep L ear- infections free so aim is to try to keep dry    Vital Signs    

Reason: Aural Heamatoma - AB Appointment Notes: Overdue remindersConsult with : daveHistory:?? Treating with antibiotics every 3 days- stopped nowCleaning with ear cleaner- tricky to do at home Examination:Removed all  R haematoma sutures- comfortable- pinna, dry, a little thick across whole pinnaEntry to R  canal more openBoth ears= +++ brown dischargeSmears= rods, cocci and small amt of yeast(smear- missed charge)DiscussedPlan- cont Tx with Aurizon daily into each earCleaning every 3 daysReturn in 14 daysReswab- if still infection send to lab for C&SO aware chronic issues re anatomy however keen to have ears more resolved.    Vital Signs