C10013596 / invoice 10000

Appointment Notes: ear infection fmvetnostics result in file. LTHistory:Owner concerns: finished his ear drops last week, but he is still itching at his ears. Going through chemo at the moment and has been up and down with that, but finally seems to be acting more himself again. O doesn't feel that the ear infection has ever cleared, this was the 3rd time they had used the ear drops, but it never took long for the infection to start back after finishing the drops. EDDU normallyNo V/D/C/SMedications: chemo through AVC, CHOP. PMP finished last week Examine:BAR, mostly good to examine, but is a little head shy, doesn't like mouth, face or ears looked at, just pulls away Cardiorespiratory: no murmurs or arrhythmias appreciated, pulses normal, lung fields clearAbdominal palpation: tense, not reactive, no masses or organomegaly appreciatedMouth: mild generalised tartar, but unable to evaluate back of mouth well due to pulling away Ears: R ear mild erythema, very itchy for swab. L ear externally comfortable. Was tricky to keep him still enough to swab, unable to otoscope exam Eyes: NADInteg: NADLNs: NADMSK/neuro: NADLaboratory:Ear cytology: R ear 15 yeast/hpf, no bacteria or neutrophils appreciated. L ear 10 yeast/hpf, no bacteria or neutrophils appreciatedAssessment:Otitis externa Mediastinal lymphoma, currently being treated with chemo Plan:Recommended trialling BMT ear paste as an alternative to PMP to see if more effective. Would consider sedated ear flush and exam, but given current chemo, is not ideal. O keen to trial a different medication. R/v for nurse ear paste 7 days, then vet recheck following week Treatment:Placed BMT ear past 4ml R ear, 5ml L ear     Vital Signs    Weight: 18.6;       MMColour: Pink;       HeartRate: 144;       RespirationRate: 32;       BodyScore: 6;       DentalGrade: 2;       CRT: 1-2;