C10010307 / invoice 20000

Reason: Recheck Ears With IMOGENEAppointment Notes: Overdue remindersHas been going well since pred stopped. Has had 10 days aurizon ear drops. Does occasional shaking of the ears but o thinks normal for him.One xma both ears clean not inflamed.Cytology clear fo rods.Start maintenance weekly cleaning and elocon 0.3ml into each ear.    Vital Signs    Weight: 12.7;       

Reason: Recheck Meds For EarsSee on 25/2 for otitisGiven dex injection then 7.5mg pred once dailyAlso Aurizon both ears once dailyLast 2 days has been really not himself.On Saturday night and on Sunday noted to be very agitated and cannot settle (like he is on speed) says o.No vomiting, no diarrhoea, Drinking A LOT . And cannot settle. Confirmed correct tablets dispensed -YESCorrect eardrops -YESExamine: Bright and alertColour pink and CRT < 2 secondsHR 80 with no murmur, chest clear Temp 39.1Bladder comfortable, abdomen comfortableEars:  both inflamed canals but TM okAssessment: suspect RARE reaction to pred, although o says has had cortisone twice before without this reactionTreatment:  NOTE: owner wasted significant amount of her Aurizon as the blue applicator did not correct fit the bottleStop pred, continue AurizonPlan:  recheck around the 10 day mark with Imogene or NRO please to call before then if symptons not resolving    Vital Signs    Weight: 12.7;