C10000447 / invoice 10000

- going well, got ear drops in rel well, sometimes needed to muzzle- stopped head shaking/ear scratching- generally also less licking paws and scratching self, prev all during day and now just a bit before goes to sleep in evening- on anallergenic r/c - fully on this only recent- had noticed reacts to chicken- prev maybe ok on roo/pumpkin prime - single protein options prime to challenge after anallergenic 4-6wks- otoscopic exam both ears - canals good, pinnae mild rash/corrugations bilateral, cytology negative- trial topical preventative to reduce chance of infection recurring- Elocon 0.6ml each ear weekly for 4 weeks then r/chk

BIB mum, daughter and son- recurrence of allergic otitis externa - L ear>R, pinnae skin corrugation, erythema, yeasty discharge L ear++, minimal discharge R ear- ear flush/clean Epiotic and instill Apex PMP - demo massage and application, had Neptra prev but is amenable to drops so o will try at home, if goes well then longer term may be option for Elocon/Cortavance preventative management- has initiated hypoallergenic diet trial, still on dental treats at present but will wean off- advised as previous option for Cytopoint, Apoquel as licks paws, scratches^- derm referral option- Apex PMP 30ml - 0.7ml bid each ear - revisit 7d

  S : BIB mum and daughter (studying Science at Melb Uni), annual health check and vaccination update due, been well, has Advocate now as diffic to give oral (was having Bravecto and Drontal 3mo and Afilaria inj in Dec)O : note on exam brown-red fur staining all 4 paws - licks paws alot - usually at night/to go to sleep, also scratches at chin, both ears bit erythemic/slightly corrugated skin at base of pinnae, MM pink/crt ok, v slight/mild tartar, eyes ok, chest auscult/heart ok, abdo palp ok, robust body condition, mobility fine, fit/active/v lively and friendly nature- diet Prime kangaroo/pumpkin, beef, Pure Life dry - chickenA : probable allergy - atopy, food allergy, etcP : Nobivac BB/Pi2 s/cB: 2505002exp 10/2026)Parasite Control: on Advocate now - remove reminder for Afilaria in Dec- discuss allergy investig (eg food trial), symptomatic management eg Cytopoint, Apoquel, paw bathing, antihist, c/s, etc, tablets diffic for admin as fussy, keen to trial diet elimination initially - info diet trial, PB handout and Vetcheck allergy info emailed, options for r/canin anallergenic or hills z/d ultra, Cytopoint brochure