C10017175 / invoice 10000

History:Since went to the beach a couple of weeks ago has seemed bothered by ears. Has had one ear infection prior to this. Also has little lump on his tail. Examine:Left ear some dark brown discharge in ear hair around ear opening. Dark brown material on swab from ear, ++++ malassezia on cytology. Down canal lining thickened with some cobblestone appearance. Right ear looks clean, nsf on cytology. On dorsal tail skin, about mid way down - area of thickening with crust on the top. Removed the top which was a round ball of dried material leaving divot/opening in the skin. With pressure expressed more +++ thick chunky white cystic material. Area of opening round, quite big approx 0.5cm. Flushed with saline. Assessment:Left ear malassezia infection.Looks like keratin cyst on tail. Not sure how well will heal and close over as opening quite large. Plan:Tapering auracol course for left ear and macrolone. Ceph 7 day course to help with the area of skin on tail. Rec recheck in a week to check if ear infection cleared and re-assess tail, discussed if not healing and closing over may need surgery to remove the area of affected skin/cyst.     Vital Signs