C09998878 / invoice 10000

Reason: Ear And Eye InfectionAppointment Notes: SY was running behind yesterday andHistory: Enzo is a 7 year and 3 month old male neutered Maltese presenting for crusting on dorsum, inguinal region, priocular erythema and ear pruritis. Been in recurrently for periocular inflammation/chemosis which is suspected to be associated with allergic conjunctivitis. Diet + appetite: eating and drinking well, Urination/defecation: normal Preventatives: UTD NGS + worming Examination: Demeanour: BARHeart: 116BCS: 5/9MM: p+m, CRT <2Eyes - normal menace. Palpebral reflex. No aquoeus flare. Plr normal. Periocular erythema and alopecia present. Ears - lots of ceruminous discharge. Tm intact .Mouth: C1G1, normal occlusion, no cleft palate MSK: able to ambulate well, normal gaitNeuro: normal mentation, no obvious cranial nerve deficits or ataxiaAbdo: no pain on palpationInteg: a few crusty colarette lesions over dorsum and inguinal + medial HL region. Laboratory: Negative woods lamp. Offered fungassay - O  deferred today. Ear cytology - L ear clear, R ear malassezia ++ Assessment: OE - malassezia bilaterally Crusty collarette lesions over dorsum and medial thigh region. Suspect bacterial pyoderma/collarette lesions, periocular inflammation, recurrent ear infections secondary to an underlying alergy. Ddx CAFR vs. Contac vs. Aotpy vs. OthersPlan:Cortavance+austrazole solution 0.5m in both ears bid 7 daysMalaseb BIW 3 weeks/until resolution of lesionsCephalexin 200mg tablets one tablet twice a day for 7 daysStart apoquel 16mg tabs - quarter tab bid 14 days then sid as maintenance. Advise O to phone for more of this to prevent recurrence of flareups.    Vital Signs