C10007943 / invoice 10000

Appointment Notes: Recheck ears (AH)  ------- Sms reply: Yes?????History:Recheck consultation for ongoing bilateral otitis. The owner reports the ears appear cleaner and Mo is not pruritic, but a slight malodour persists. The owner has been performing fortnightly ear cleaning with a previously dispensed flush. The owner also mentioned Mo seems "so hot" and is being trained for separation anxiety, now tolerating being alone for up to five hours.- Significant history: Recurrent otitis externa.- Current medications: Otic flush - every two weeks.- Appetite & diet: Not discussed.Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperemia, no epiphora.- Ears: Mild debris and malodour present bilaterally. Condition is improved from previous examination.- Oral: Grade 0 dental disease.- Nose: NAD.- Cardiovascular: No murmurs or arrhythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Normal coat, no ectoparasites.- Abdomen: Soft, no masses palpated.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Not assessedAssessment:Problem List:* Otitis externa (yeast) - improving.* Separation anxiety - reported by owner, currently being managed.Treatment:Plan:* Bilateral ear clean performed in-clinic.* Dispense another course of current otic medication to clear residual yeast infection.* Continue fortnightly ear cleaning at home.* Plan to dispense a weekly preventative otic solution once infection has fully resolved.* Recheck consultation in one week to ensure resolution.Client Communications:* Discussed the importance of completing the full treatment course to prevent recurrence of the infection.* Advised on the long-term management plan, including weekly preventative treatment and continued fortnightly cleaning.* The owner is travelling for one month from the end of June. Advised to leave the clinic's emergency contact details with Mo's carers.?????    Vital Signs