C10020038 / invoice 10000

Hx: Here for ear revisit. O thinks he is going in the right direction. O has no other concerns. Due for synovan injection. Cex: BAR MM: pink, moist CRT2sMicroscopy: R ear: NSF L ear 1+ Malassezia Assessment: Ear disease is resolving Tx: 1ml synovan given SC Plan: Continue dermotic in both ears for 5 to 7 days. After 2 weeks start elocon 1ml topically ONCE weekly ongoing. Prevent Darwin to go in the water

Hx: Here because Darwin has been showing signs of ear disease after a big swim. R ear is red and mucky. Shakes head profusely after swim. Does not let O touch the ears and has a slight head tilt towards the right. No change in EDDU. No V/D. Has had fungal ear disease in the past which resolved with medicated ear drops.  CexBAR MM: pink, moist, crt 2s Chest: clear HR: 120, no murmur ,no arrhythmia Abdo: NSF Peripheral pulse: strong, regular and synchronised with HR Peripheral LN: WNL Assessment: Otoscopic exam not tolerated awake Ear otoscopic exam R ear: erythema, canals are stenotic, mild amount of dark brown discharge, TP seems intact L ear: canals are NSF, small amount of dark brown discharge Microscopy: R ear: 4+ malassezia and 1+ cocci L ear: NSF Tx: Admitted for sedation and ear check. Sedated with 0.7ml medetomidine and 0.3ml butorphanol IM. Still reactive, so induced with 3ml alphaxan IV.  Both ear were checked with otoscope, Swabs taken. Both ears were flushed with otoflush. Dermotic applied to both ears. Reversed with 0.7ml atipamezole IM. Recovery was uneventful Plan: TGH on dermotic in R ear for 10 days and metacam PO SID dose to 29kg for 5 days. RV in 10 days to check ears

Oticlean