C10028311 / invoice 20000

Treatment: Sedation butorphanol 0.3mg/kg + medetomidine 10ug/kg IM @ 1250pmCatheter placed RFLEars examined w otoscope  ++ hairs and crust  Inflammation of horizontal canal partic L side Alfaxalone top up IV due to discomfortEar cytology performed:  L ear + yeast, debris   R east + yeast, debris Dermotic both ears Mouth/oral exam NAD Laboratory: Blood taken to run test in house.CBC: WNL Biochemistry: WNL Client Communication: --- 13/03/2026 15:08:59 TL:Client called and informed of resultsConsent for dermotic to be administered. O okay to give at home Plan: Discharge @420pm w TLPost-sedation care for Flash Flash had a short sedation today and has recovered well.  Please follow the below instructions carefully to ensure a smooth recovery:?	It frequently takes 24-48 hours for an animal to completely recover from a general anaesthetic.  Please keep them warm and inside during this time and if needing to toilet, take them outside on a short lead?	Please offer small amounts of food for the first 24 hours. It is not uncommon for some animals to feel nauseous post-operatively?	If buster collar has been supplied to prevent trauma, please ensure it is worn at all times for 10-14 days, unless advised by your veterinarian?	If medications have been prescribed, please make sure you understand the dosage instructions. If Flash shows any signs of vomiting, diarrhoea, inappetence or blood in the stool then please discontinue the medication and contact us immediatelyIt has been a pleasure in taking care of Flash today. If you have any concerns regarding their progress, please do not hesitate to contact us.Follow up appointments:Flash needs to be seen in _______ daysFlash’s appointment is on: ________________ at : ________________    Vital Signs    

Reason: Check MouthAppointment Notes: AB's have finished, mouth seems a bit sore still. Scratches mouth and squeals. o refused PVP at this point. They are aware they will need to come back with PVP on board if we are unable to examine the mouth today with out PVP - ajsHistory:Presenting for: Flash presented for follow-up of mouth issues and pruritus following recent treatment with antibiotics and Cytopoint injection.Historical Conditions:- Recent visit for assumed mouth irritation. Has been rubbing face and yelping occassionally. Current Meds:- Last day of AB course - Cytopoint injection administered at previous visitExamination:Behavioural: Tolerant for mouth exam Oral: Teeth NAD with low grade tartar only, lips normal, no significant dermatitis noted around mouth or inside lips Ears: Pinnae not obviously red or inflamed, patient pruritic when ears examined partic L ear , unable to perform complete otoscopic examination due to patient intoleranceAssessment:Pruritus - DDx: ear infection, foreign body (grass seed), underlying allergic disease. Recent Cytopoint injection should have controlled allergic pruritus, suggesting other causes more likely.Plan:Diagnostics:- Sedation and bilateral ear examination with otoscopy recommended to assess for foreign bodies or infection- Ear swabs for cytology if indicated based on examination findings- Cost estimate provided at approximately $500 (sedation, examination, and potential swabs only, excludes any medications)- Client to discuss with family and contact clinic to proceedForms to be printed for client referenceConsent signed PABT performed    Vital Signs