C10031722 / invoice 10000

Reason: VaxReasonAnnual vaccination and assessment of ears.HistoryBeen having recurrent ear infection Otherwise well ExaminationMentation: Bright, alert, and responsive  BCS: 3/5  MM: Pink, moist  CRT: 1 second  HR: 120 BPM  R: Panting  Lymph Nodes: Within normal limits  Temperature: Not taken  Ears: L ear impacted with a large amount of thick discharge. The canals are very inflamed and sore.  Cytology- yeasts +++R ear NADDental: S2 on upper carnassials Cardiovascular: No abnormal findings - no heart murmur or arrhythmias detected.  Respiratory: No abnormal findings - no respiratory depression or effort.  Abdomen: No abnormal findings. Comfortable on palpation.  Musculoskeletal: No abnormal findings  Integument: The skin is otherwise unaffected.  AssessmentDdx: unilateral otitis externa.Treatment-   Vaccinations administered (oral and SQ injection). C4, BB oral -   dermotic BID, otoflush BID-   pred 10mg SID for 7 days then tapering (start 15/3)Plan-   Recheck in 10 days to assess the ears and ensure the infection has resolved.-   Long-term management with maintenance ear drops (twice weekly) will be discussed once the current infection is confirmed to be resolved.    Vital Signs    Weight: 28.4;