C10027407 / invoice 10000

Reason: EarsAppointment Notes: Overdue reminders LeftVerified: NoReason: Ear infectionHistory:Dog has been with owner for a couple of daysKept owner awake shaking head at nightOwner applied green PMP ear drops (medication from previous dog Roy)Dog susceptible to ear infectionsWas in river recentlyDog splits time between two familiesHad itching after Christmas which settledFamily gave dog shower after holidays, brought back SundayOwner noticed head shaking Monday nightExamination:BAR in consultMMs: pink & moist, CRT < 2secEars: L ear mucky with dischargeCardio: no murmur or arrythmiaResp: Lung sounds clear, normal respiratory effortAbdo: comfortable on palpation, no palpable massesIntegument: NADLNs: normalLaboratory:CYTOLOGY ears: L ear swab takenAssessment:L ear infection secondary to water exposure and environmental factorsPlan:Ear cleaning performedEar drops BID L ear for 2 weeksConversation with owner:Discussed that ear infections are usually secondary infectionsExplained association with floppy ears, warm humid weather, and water exposureAdvised treatment should settle infection quickly    Vital Signs