C10023383 / invoice 10000

Reason: EarsAppointment Notes: Overdue remindersReason: History: Has had trazodone x2 and gabapentin x3 1.5 hours ago. Ears itchy again. Panting more. Panting more, normal energy, normal eating, drinking weeing, pooing. No coughing or gagging since the episode in September.Parasite Prevention : utdExamination: Inflammed gingiva in several areas, away from gingival margin, also has periodontal dx and gingival marging inflammation where tartar is thicker grade 1-2/4. Ears look visually normal, can't do otoscope exam safely. Cytology - squames only both ears, no malassesia seen this time.Assessment: Responding to pred, allergy otitis. Treatment: Apply neocort to outer ear if he tolerates that twice daily 7 days. Also apply easotic today (while has had gaba/traz) and continue that once daily after giving gaba if owner wants to for cortisone effect/comfort in the deeper ear canal. Also give pred 20mg  once daily for total 2 weeks then every second day before stopping for further week.Plan: Recommend dental and if inflammation has not settled with pred. Recheck in 2 weeks to discuss how he has gone and recheck gums and panting before day of dental.    Vital Signs