C09998759 / invoice 20000

Species:CANINE
Breed:French Bulldog
Age (years):8
Diagnosis or signs:Checkup
Consult notes
05/03/2026 HISTORY
Presenting for: Maya presented for routine medication review and vaccination update.
Historical Conditions: Chronic atopic dermatitis with pruritic ears but no recent ear infections
Current Meds: Apoquel Chews 16mg 1/2 tablet twice daily,  Prednisolone 5mg 1/2 tablet every second day, NexGard Spectra for parasite control, Dermotic topical ear medication (antibiotic/anti-inflammatory combination) prescribed by Dr Andrew approximately 3-4 years ago - client requires new bottle

EXAM
Integumentary: Small skin tag noted on inside of back leg - black, 2mm diameter, pedunculated. 
Another one on back of neck. 
BCS 4/9
Skin/coat - erythema patchy to neck/face/distal limbs and mild to interdigital skin. Also seems to have pruritic ears but no debris - attempted otoscope, able to do R ear but not L as became to bitey. Gets very upset but ear exams! No debris, canal inflamed. 
CVS exam wnl
Abdo palp relaxed and nsf
MSK wnl

ASSESSMENT
Chronic atopic dermatitis - well controlled on current medication regimen
Last vaccination November 2022, triennial vaccine due

PLAN
Vaccinations:
- Triennial vaccination due - Given DHP

New Meds/Tx:
- Elocon 0.5mL weekly to ears to improvement inflammation/pruritis

Continue Pred and Apoquel as above - repeats on file. 

Additional Discussion:
- Discussed baseline blood test around 7 years of age, then potentially annual monitoring from 8-9 years of age rather than every 6 months
- Current medication regimen maintaining good control of allergic skin disease
- Ears remain pruritic but no active infections occurring

05/03/2026 CBC (mild lymphopenia). Biochem wnl aside from low ALP, Chol, Lipase - not significant. 
Advised O' that bloodwork all normal. 

Animal clinical history (3 most recent)

2026-03-05T00:00:00Z 15:45:05
HISTORY
Presenting for: Maya presented for routine medication review and vaccination update.
Historical Conditions: Chronic atopic dermatitis with pruritic ears but no recent ear infections
Current Meds: Apoquel Chews 16mg 1/2 tablet twice daily,  Prednisolone 5mg 1/2 tablet every second day, NexGard Spectra for parasite control, Dermotic topical ear medication (antibiotic/anti-inflammatory combination) prescribed by Dr Andrew approximately 3-4 years ago - client requires new bottle

EXAM
Integumentary: Small skin tag noted on inside of back leg - black, 2mm diameter, pedunculated. 
Another one on back of neck. 
BCS 4/9
Skin/coat - erythema patchy to neck/face/distal limbs and mild to interdigital skin. Also seems to have pruritic ears but no debris - attempted otoscope, able to do R ear but not L as became to bitey. Gets very upset but ear exams! No debris, canal inflamed. 
CVS exam wnl
Abdo palp relaxed and nsf
MSK wnl

ASSESSMENT
Chronic atopic dermatitis - well controlled on current medication regimen
Last vaccination November 2022, triennial vaccine due

PLAN
Vaccinations:
- Triennial vaccination due - Given DHP

New Meds/Tx:
- Elocon 0.5mL weekly to ears to improvement inflammation/pruritis

Continue Pred and Apoquel as above - repeats on file. 

Additional Discussion:
- Discussed baseline blood test around 7 years of age, then potentially annual monitoring from 8-9 years of age rather than every 6 months
- Current medication regimen maintaining good control of allergic skin disease
- Ears remain pruritic but no active infections occurring
2025-01-28T00:00:00Z 15:23:55
In with Yoda for a visit. On 2.5mg eod pred together with Apoquel and skin/ears are good currently.
2024-08-12T00:00:00Z 11:09:27
Tail fold dermatitis. Cytology moderate numbers of malassezia and GPC. Anal sacs were not full. 2w Clav and ketoconazole as before. Redisp Apoquel and pred (see label for current dose). Also 2mm diameter sebaceous cyst R lip of vulva, pierced with 22g needle and expressed.

Previous claim history (3)

DateClaim #Diagnosis
2021-04-07C3647751COUGHING
2021-04-04C3642023COUGHING - PRESENTING COMPLAINT
2020-11-03C3273393ALLERGY

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_corticosteroids54.902026-03-05

UPM+

  • DG02339HYPERSENSITIVITY DISORDER (ALLERGY)DSTP_skin_-_allergic_disorder

Variant (sleepy_king)

HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.880
Threshold: 0.38
Above:
Correct?