C10006578 / invoice 10000

Reason: Heat StrokeAppointment Notes: Paws App Details:Booking Type: ConsultationBooking Vet: Dr Markus ManderBooking Notes: Maddie had Heat Stroke on Monday 2 March. She’s been in hospital at Homebush & hope to be released later today, Wednesday 4 March. I’d like you to check her out please. Pet Insured: Yes  ------- Sms reply: yesVerified: NoHistory:Presenting for: Maddie presented for follow-up examination following previous ear infection treatment and possible pregnancy Assessment: after unsuccessful mating attempt 4-5 weeks ago.Historical Conditions:- Previous ear infection treated with ear medication (within past 6 months)- History: of singleton pregnancy previously detected on ultrasound- Chronic recurrent ear infectionsV/D/C/S:- Diarrhoea - small amounts with frequent soiling, described as squirts- No actual visible stool production, just soilingCurrent Meds:- Ear medication from previous infection (dispensed November, approximately 17mL used from bottle)Other:- Attempted mating 4-5 weeks ago but dogs did not tie successfully- Owner noticed dog felt different on abdominal palpation- Regular grooming with ex-veterinarian groomerExamine:Wt: 7.4 kg (decreased from previous visit)Ears: Left ear - malodorous discharge, erythema, malassezia infection confirmed. Right ear - normal appearance. Excessive hair growth in ear canals noted.Abdominal: Palpation findings suggestive of possible pregnancy but inconclusiveAssessment:Bilateral otitis externa - Left ear active malassezia infection, right ear normal. Recurrent nature suggests possible underlying allergic disease. Poor ear ventilation due to excessive hair growth contributing to problem.Possible pregnancy - Inconclusive on palpation, requires ultrasound confirmation given 4-5 week timeframe post-mating attempt.Plan:New Meds/Tx:- Continue existing ear medication for both ears BID for 2 weeks (may require additional bottle if current supply insufficient)- Left ear cleaned and hair trimmed to improve ventilationDiagnostics:- Ultrasound scheduled 23/3 at 11:20 with James for pregnancy Assessment: and ear recheck (30-40 minute appointment)Additional Discussion:- Discussed ear hair plucking with groomer to improve ventilation and reduce recurrence- If ear infections continue to recur, may consider anti-inflammatory ear drops for weekly maintenance rather than repeated antibiotic use- Recheck in 2 weeks essential to confirm resolution and assess treatment success versus underlying allergyClient Comms:- Owner to contact groomer regarding ear hair plucking- Return in 2 weeks for ear recheck and pregnancy ultrasound- Additional ear medication available if current bottle runs low before recheck    Vital Signs