C10009886 / invoice 10000

Appointment Notes: Itchy, stinky ears bilateral PB 10/3Verified: NOHISTORYPresenting for: Ziggy presented for recurrent bilateral ear infections with erythema, flaking, and pruritus.Historical Conditions:- Last year had approximately 6 months of nearly continuous ear infections requiring weekly visits- 8 months since last ear infection episode- Had yearly vaccination earlier this year resulting in sizable bump on spine at injection siteSkin:- Ears become red and flaky as early indicator of infection- Severe flaking and dermatitis with buildup in ear canals- Intense scratching behaviour- Owner reports extensive flaky skin debris when attempting to clean earsCurrent Meds:- Cortavance (maintenance dose) - sweet formulation, administered via syringe- Increased to once daily when early signs of infection noted- Owner attempted treatment over weekend but infection progressedEXAMEars:- Bilateral otitis externa present- Right ear more severely affected with significant swelling preventing sample collection- Left ear less severely affected- Extensive flaky dermatitis and debris buildup in both ear canals- Erythema and pruritic lesions notedASSESSMENTBilateral otitis externa - Mixed infection suspected (yeast and bacterial) based on clinical presentation. Chronic recurrent condition with underlying dermatitis component.PLANNew Meds/Tx:- Aurizonia 0.4mL to both ears once daily- Additional syringes provided for administration- Discontinue Cortavance while using Aurizonia due to strong cortisone content in new medicationAdditional Discussion:- Discussed Malaseb for Malassezia infections in paws when needed- Mentioned Aloveen as alternative maintenance option- Client enquired about post-vaccination lump on spine - advised this can be normal reaction to annual vaccination    Vital Signs