C10005062 / invoice 10000

Reason: NPC - Possible Ear Infection (JP)Appointment Notes: Overdue remindersHistory:Ongoing right ear irritation. Previously treated an resolves but then comes back again. Does not lick paws and no other signs of allergy. Occasional swimmerExamine:In general good condition, owner has been making up own diet. Weight stableMM: PinkCRT: < 2 secsAbdo palp normalLymph nodes all normal sizeEyes nadEars:- Left: Normal on exam- Right: Narrow ear canal, very inflamed, polyp vs inflammation caudal area at base of vertical ear canal. Swab shows +++++ Malazzesia, no bacteriaAssessment:Right eye otitis externa - yeast. Suspect underlying cause: allergies, polyp, narrow ear canalTreatment: Discussed options with owner - videoscopy to rule out polyp etc, g/a and flush, trial longer acting meds to settle chronic inflammation, consider allergy meds- Cleaned ear - Placed 0.8mls of mometamaxPlan: Recheck in 4 weeks. Reassess re allergy medsEstimates given for any procedures discussed.Consent forms signed for all admissions/procedures.    Vital Signs