C09985977 / invoice 10000

Just got a call from the O, she is wondering does she need to continue Macrolone? She has been giving the 1/4 and then as Halo has been still scooting a little she has been giving more. I told her to just give the 1/4 tablet as per label as this medication needs to be tapered. Happy to call her and give update. She seemed confused. KatSee above. JT tried calling yesterday, no answer, LVM. Tried again today, no answer, LVM. Had ~22 days worth of CCS, so will be finishing last dose tomorrow.Plan was to continue with low dose steroid if managing Halo's itch, or consider alternative eg apoquel.--- 12/02/2026 15:26:47 JAT:Spoke with O. Rediscussed that aim was to assess efficacy of low dose CCS to see if these are appropriate for maintenance anti-inflamm for Halo. O feels was very well managed on 5mg prednisolone SID, fairly well managed on 5mg EOD but some itching. Adv 5mg SID is an appropriate maintenance dose. Will switch to prednil for ease of dosing, and has anti-histamine in it as well which may help. Reminded that long-term CCS use can result in various adverse effects eg hepatopathy, even at lower doses. Alternatives available for anti-inflamm/anti-pruritus, such as apoquel, but these are more costly. O adv that these options are cost-prohibitive. Rediscussed plan for OE treatment. O gave another treatment yesterday (~9d after first dose). Optional to administer a third dose, especially since infection was mild - O will proceed with this. Recheck 2 weeks after last treatment to see whether infection cleared, and hopefully assess TM patency to determine which maintenance otic anti-inflammatory is appropriate. As discussed, this is likely to require injectable sedation. While oral CCS on their own may help prevent repeat OE, feel in Halo's case it would be best to use both concurrently.    Vital Signs