C10021452 / invoice 10000

Reason: Recheck Ears Heidi Yes Appointment Notes: Overdue remindersSubjective:C/O ear infection still not resolved after previous dose of neptra.Owner notes discharge in the horizontal ear canal that lingers despite medication.Objective:Otoscopic examination: significant malodorous discharge present within the vetrical ear canal.Laboratory:   Cytology ++ malassezia + cocci L earAssessment & Plan:1. Recurrent Otitis ExternaDifferential diagnosis: Biofilm issue, underlying allergy, conformational issues, foreign body, resistant infection, obstructive mass.Plan: Discussed three options with the owner.Option 1: Trial of an alternative topical medicationOption 2: General anaesthetic for a thorough ear flush and clean. An estimate will be emailed to the owner.Advised O that GA and flush is not a guarantee to fix the issue.  Referral to a specialist for further workup, including video otoscopy and potentially advanced imaging (CT scan) may be required.Owner to consider options and decide on the plan. Will email estimate for GA and flush, recommended booking this in soon.    Vital Signs    Weight: 41;