Multi-Model Clinical Review

CASE EVIDENCE BUNDLE v1 ======================= PATIENT ------- Name: Eddy Owner: Bright Species: Canine Breed: Border Collie Sex: Male Desexed Status: Life Stage: Activity Level: Current Weight kg: 23.00 Ideal Weight kg: BCS: 7.00 CASE ---- Case ID: 20 Title: New Clinical Case - 08/06/2026 05:39 Primary Complaint: Status: Open Date Opened: 08/06/2026 CLINICAL NARRATIVE ------------------ Head tilt, head skaing and walking ion circles crying when scratching legft ear Inner Wolf Chicken 2 x chicken wings 1 Joint Guard INITIAL DIFFERENTIAL NOTES -------------------------- CLINICAL INTAKE DOCUMENTS ------------------------- Count: 1 Document: Clinical Intake - 08/06/2026 05:40 Type: Clinical History Source: Clinical intake / AI consult Uploaded: 08/06/2026 05:40 Head tilt, head skaing and walking ion circles crying when scratching legft ear Inner Wolf Chicken 2 x chicken wings 1 Joint Guard NUTRITION EVIDENCE ------------------ Nutrition source rule: calculations must use accepted Review Centre food, treat and supplement entries, not raw clinical intake text. Nutrition assessments: 1 Latest Assessment ID: 82 Date: 08/06/2026 Feeding Goal: Maintenance Current Diet Type: Mixed / to be verified Body Weight kg: 23.00 Ideal Weight kg: BCS: 7.00 Appetite: Not recorded Digestive Notes: Stool Quality: Skin / Coat Notes: Owner Reactive Foods: Owner Tolerated Foods: Nutrition Calculation Summary: Energy: 2221.7 kcal/day Protein: 193.6 g/day Fat: 170.25 g/day Carbohydrate: 12 g/day Accepted Review Centre Calculation Lines: - Chicken Raw Bites | 1200 g/day | 1864.2 kcal | Match: Matched | DAMNIT-V reactive groups: purine - Chicken, ground, raw | 250 g/day | 357.5 kcal | Match: Matched | DAMNIT-V reactive groups: RAC / AUDIOMIXER EVIDENCE ------------------------- RAC reports: 0 Positive classified RAC markers: 0 RAC MARKERS BY DAMNIT-V DOMAIN ------------------------------ No positive classified RAC marker results currently attached to this case. PATHOLOGY / LABORATORY EVIDENCE -------------------------------- Pathology reports: 0 IMAGING EVIDENCE ---------------- Imaging reports: 0 EVIDENCE BUNDLE NOTE -------------------- This bundle is the shared evidence source for Snapshot and Multi-Model review. Case-specific DAMNIT-V reasoning should be generated from this bundle, not from isolated keyword rules.

Conventional Veterinary Model: - Presenting problem summary - Head tilt. - Head shaking. - Walking in circles. - Crying when the left ear is scratched. - Likely differentials - Otitis externa. - Otitis media/interna. - Peripheral vestibular disease. - Serious rule-outs - Central vestibular disease. - Ear canal foreign body. - Missing tests - Otoscopic examination. - Ear cytology. - Neurological examination. - Imaging (CT/MRI) if neurological signs persist. - Monitoring markers - Response to ear treatment. - Changes in vestibular signs. - Concurrent patient-state findings - Body condition score 7/9 indicates overweight. - Diet includes raw chicken wings and ground chicken. - No RAC markers detected. - No pathology or imaging data available. Traditional Chinese Medicine Model: - Possible patterns - Damp-Heat in the ear channel suggested by scratching and pain. - Qi stagnation due to discomfort and head shaking. - Possible Wind invasion causing vestibular signs. - Food energetics - Chicken is warm and nourishing, may contribute to internal Heat if in excess. - Overweight status may indicate Spleen Qi deficiency or Damp accumulation. Homeopathic Model: - Remedy-picture themes - Symptoms suggest irritation and inflammation of ear structures. - Modalities needed include aggravation by touch and scratching. - Constitutional observations missing for temperament and general behavior. - Missing characteristic symptoms - Specific modalities such as time of day, weather influence, and emotional state. - Details on discharge or odor from ear absent. Anthroposophic Model: - Nerve-sense system involvement indicated by vestibular signs and head tilt. - Rhythmic system may be affected due to balance disturbance. - Metabolic-limb system may be stressed by inflammation and pain. - Life process themes include sensory perception and equilibrium. - Organ-process themes involve ear and nervous system coordination. Cross-Model Agreement: - All models indicate ear involvement and nervous system disturbance. - Conventional and TCM models align on inflammation and possible infection. - Homeopathic and Anthroposophic models emphasize sensory irritation and systemic balance. - Divergence in TCM focus on Damp-Heat vs. Anthroposophic focus on systemic rhythms. - No conflicting evidence on primary affected system. Rule-In / Rule-Out Priorities: - Rule-in - Otitis externa/media/interna. - Peripheral vestibular disease. - Rule-out - Central vestibular disease pending neurological exam and imaging. - Ear canal foreign body pending otoscopy. - Evidence pending - Cytology and culture of ear discharge if present. - Neurological assessment for central causes. Testing / Treatment / Diet Trial Priorities: - Physical tests - Otoscopic examination. - Ear cytology and culture. - Neurological examination. - Diet / nutrition review - Assess calorie intake given BCS 7/9 (overweight). - Consider reducing high-fat raw chicken wings. - Supplement review - Review Joint Guard supplement for relevance. - Response-to-treatment markers - Improvement in head tilt and scratching behavior. - Reduction in pain on ear manipulation. - RAC follow-up priorities - Monitor for any emerging RAC markers if new symptoms develop. Next Snapshot Trigger: - Results of otoscopic and cytology exams. - Neurological examination findings. - Response to initial ear treatment. - Changes in vestibular signs or new neurological deficits. Clinical Caution: - This is not a diagnosis. - Veterinarian must interpret findings in clinical context. - Further diagnostics required to confirm cause of vestibular signs.