C10015258 / invoice 20000

Reason: Ear FlushLABORATORY: USG 1040 otherwise WNL on dipstick - prerenal elevations on bloods ANAESTHETIC: dom/torb i/v LABORATORY: yeast only (charged on previous visit) EXAMINATION: L ear clearR ear copious brown discharge TREATMENT: flushed with dilute malaseb and then saline - unable to visualise TM as very swollen canal Dexason inj , PMP instilled Nails trimmed PLAN: re-view 10d, warn risk of ototoxicity - if any neuro signs/head tilt stop medication    Vital Signs    

Reason: Double Ear Infection Appointment Notes: told to fast incase sedation is needed HANLABORATORY: mild inc creatinine PLAN: get urine sample to check USG    Vital Signs    

Reason: Double Ear Infection Appointment Notes: told to fast incase sedation is needed HANHistoryDaisy presents for red, inflamed right ear- Right ear inflammation noted approximately one week ago- Head shaking and rubbing on furniture- Pain and avoidance when touching around ear area- Normally tolerates ear handling well due to desensitisation training- Otherwise eating and behaving normally- Recent adventure under house with companion dog_______________________________________ExamBAREyes: NADEars: L ear NAD, R ear: heavy yeast burden, no bacteria or inflammatory cellsOral: NAD, CRT <2s mmpm, grade 0/5 dental dzHeart: NAD, normal rate and rhythm no audible murmursResp: NAD on auscultation, normal rate and effortIntegument: NADAbdomen: NAD on palpationMSK: NADPeripheral Lymph Nodes: NAD on palpationTemp: not taken_______________________________________Subjective- Right otitis externa - ddx foreign body (grass seed), bacterial infection, yeast infection_______________________________________Diagnostics_______________________________________Plan- Sedation for thorough ear examination and cleaning to rule out foreign body- Pre-anaesthetic blood test ($115) to assess kidney and liver function - client consented- Client consented to sedation procedure- Discussed potential for grass seed foreign body given farming environment- Client confirmed ability to administer ear medications at home- Patient to be admitted for morning surgery schedule- Client to be contacted when ready for discharge_______________________________________    Vital Signs    Weight: 26.8;