C09994338 / invoice 10000

History:- Recurrent pruritus. Owner reports licking paws and very red ears noted last night. Last flare-up was 23/10/2025.Ears:- Both ears examined. No significant discharge or signs of secondary infection. The majority of the redness is noted at the pinnal opening. Left ear is more inflamed than the right.Integument:- Licking front paws. Paw skin appears red but not significantly inflamed or infected.Assessment:- Problem list:1. Allergic otitis externa.2. Pedal pruritus, secondary to atopy.Plan:- Cytopoint injection 30mg given subcutaneously.- Elocon otic drops prescribed. Owner to administer 1ml once daily for one week to both ears.- Owner to continue to use Elocon on paws if pruritus persists.- Recommended cleaning ears prior to medication application.Communications:- Discussed with the owner that Cytopoint is effective for skin pruritus but less so for otitis. Elocon is required to resolve the ear inflammation. Advised that early intervention has likely prevented a more severe flare-up and secondary infection.

Hx:presented for cytopoint injectionatopy well controlled on 30mg 3 monthlyTx:cytopoint 30mg SC

Just started to have an inflammed R ear within the last 24-48 hours.R ear - top of canal inflamed, down canal slightly red at top of vertical canal but clear down further and TM intact.No discharge.L ear good.Treatment -1ml Elocon in R ear for 3 days then on going in both ears 1ml SIW.If this isn't settling down in 3 days may need to dispense Easotic.