C10019477 / invoice 10000

Appointment Notes: 11/3 - 8.30 - called - no answer ? would they like morning appt? moved up 5 mins to 3pm also CZBenson (Dog) - Consultation [Veterinarian : Cairns Vet Consults(No Preference)] - Ear infection -  - 0476421819 - -Elizabeth - Martinez ChungWeb BookingClient name: Elizabeth Martinez ChungContact number: 0476421819Email address: Emch2390@gmail.comPatient name: Benson???SUMMARY* 1Y 8M Lhasa Apso presented for a one-week history of a smelly, painful right ear with associated head shaking and scratching.* Cytology confirmed bilateral yeast otitis externa, significantly worse in the right ear.* Prescribed topical ear medication. Plan to recheck in three weeks to ensure resolution.HISTORY* One-week history of head shaking, scratching, and a malodorous right ear.* Owner noted erythema and some blood in the right ear canal.* Symptoms began sometime after changing groomers a few months ago. First occurrence.* Generalised pruritus reported in past (but ok today).* Receives Bravecto and Drontal for parasite prevention q3m, sourced externally (o reports these are UTD)* EDDU normal, no CSVD, BAR at home.* O has no other concerns.EXAM* Demeanour: BAR; nervous* Body condition score: 5/9* Mucous membranes: moist, pink, CRT < 2sec* Teeth: grade 0/4 perio* Eyes: eyes clear, no signs of conjunctivitis, pupils symmetrical and normal size* Ears: Left ear clean with minimal debris. Right ear canal erythematous, malodorous, painful on palpation, with a large amount of brown waxy exudate.* Head/nose/neck: appear normal, no lesions or nasal discharge observed* Heart: heart rate is normal, regular rhythm, synchronous pulses, no murmur detected* Lungs: respiratory rate and effort are normal, clear lung sounds all fields, no crackles/wheezes heard* Abdomen: abdominal palpation normal, no pain or obvious masses identified* Coat & skin: Generalised pruritus reported. No unusual masses noted, normal skin tent. No evidence of hair loss, sores or parasites.* Ambulation & MSK: normal ambulation in consult and no obvious lameness. * Lymph nodes: all palpable LNs are WNLCYTOLOGYL ear malassezia 1.5/5R ear malassezia 4/5ASSESSMENT* Bilateral Otitis Externa (Malassezia overgrowth); R>LPLAN* Cortavance/imaverol solution SID for 5d, then q2-3d for 10 days* Recheck consultation in 3 weeks for repeat cytology.* Advised to cease medication 5 days prior to recheck.* Vaccinations due October 2026, reminder to be sent.CLIENT COMMUNCIATION* Explained diagnosis of yeast otitis, a common issue in the breed due to moisture becoming trapped by hair in the ear canal.* Demonstrated correct ear drop administration technique, dose, and importance of using separate syringes for each ear to prevent cross-contamination.* Advised on home care: cleaning visible debris from the outer ear with a damp cotton ball before medicating and ensuring groomers dry ears well after bathing.* Discussed potential for long-term preventative therapy (e.g., weekly or fortnightly) to be reviewed at the recheck.* Recommended increasing bathing frequency to weekly or fortnightly to help manage generalised pruritus.???    Vital Signs    Weight: 7.5;