C10013434 / invoice 10000

Appointment Notes: re-check of ear with Dr Justina - cnDear Glen,Your vet Dr Justina is dealing with an emergency situation at the moment and will not be able to see you at the planned appointment time  of 2pm today.  Could you please call us on 9499-3691 asap so we can re-schedule a suitable appointment for you.RegardsCaryn - Receptionist Ivanhoe Vet ClinicRang - rebooked for 4pm - cn-------------------------------------------------H: presents for recheck of left otitis. scant cocci on cytology 10 days ago but marked inflammation/sensitivity on otoscopic exam so couldn't assess deeper. Was on dermotic 1ml BID left ear 10d and course or oral steroid (last dose tomorrow).  OR no scratching/head flicking observed, not bothered by ears and eddu normally. Has noticed weight loss however (~1kg since 11d ago). Is primarily on raw mince + j/d kibble - no changes and has been finishing food. E: BAR, left ear moderately inflamed pinna with crusted exocriations at entrance. Vertical canal clean, TM visible and intact, no FB visible. R-NSFD: Cytology of ears + left inner pinna - 1-2 cocci over entire slide of left pinna and vertical canal. R ear - scant malassezia.A: infection has responded to tx so AB resistance or compliance issue is unlikely. Allowed otoscopic exam today so oral steroids have helped to reduce inflammation. Degree of inflammation and evidence of self trauma over left ear raises suspicion for pinnal infection vs FB that was not visible today. T: continue dermotic 1ml both ears BID for 3d. Advised to wear gloves and spread some product over the inside of left pinna also. Advised to use ecollar to prevent self trauma to better assess degree of pinnal inflammation next visit. Finish last dose of pred.P: Recheck in 5 days. If left ear still visibly raw/irritated with scant organisms, next step is referral for video otoscopy. Also advised to feed more proportion of kibble and decrease meat portion to ensure adequate nutrition. If weightloss progresses, consider bloodwork.    Vital Signs    Weight: 25.5;