C10003046 / invoice 10000

Reviewer

Species:CANINE

Breed:Labrador Retriever

Age (years):6

Diagnosis or signs:Check ears

Consult notes

13/02/2026 O stopped macrolone as Elvis was panting constantly. Stopped when he was getting 10mg once daily. Last dose was Wednesday. O has been using panapex and dc has been improving but not resolved yet. Less itchy and irritated but still shaking head, licking at prepuce and right eye still has intermittent mucopurulent dc. Definitely improving just slow. Elvsi seems reasonably comfortable in himself.
PE: L ear erythema with mild dc. R ear no erythema but mild dc and pruritis on swabbing. Right eye mucopurlent dc. Mild preputial dc. No erythema of penis on extrusion. Rest of examination as previous. HR120, reg. BCS 6.5/9.
Path: Partial response on ears, bacterial over-growth now evident on L ear.
Tx: To monitor response to second dose of Osurnia. To restart elocon in a fortnight, check and clean as needed from then. To restart macrolone on alternate day dosing. Expect he will pant but only stop if GI upset or lethargy noted. To continue panapex for eye and prepuce for another week.
To recheck if not resolving after 2wks or gets worse at any stage.

Animal clinical history (3 most recent)

2026-02-13T00:00:00Z 18:05:19

O stopped macrolone as Elvis was panting constantly. Stopped when he was getting 10mg once daily. Last dose was Wednesday. O has been using panapex and dc has been improving but not resolved yet. Less itchy and irritated but still shaking head, licking at prepuce and right eye still has intermittent mucopurulent dc. Definitely improving just slow. Elvsi seems reasonably comfortable in himself.
PE: L ear erythema with mild dc. R ear no erythema but mild dc and pruritis on swabbing. Right eye mucopurlent dc. Mild preputial dc. No erythema of penis on extrusion. Rest of examination as previous. HR120, reg. BCS 6.5/9.
Path: Partial response on ears, bacterial over-growth now evident on L ear.
Tx: To monitor response to second dose of Osurnia. To restart elocon in a fortnight, check and clean as needed from then. To restart macrolone on alternate day dosing. Expect he will pant but only stop if GI upset or lethargy noted. To continue panapex for eye and prepuce for another week.
To recheck if not resolving after 2wks or gets worse at any stage.

Previous claim history (14)

Date	Claim #	Diagnosis
2026-02-06	C09863820	EAR INFECTION
2026-01-09	C09733061	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2025-12-02	C09579015	HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2021-12-30	C4358191	ALLERGY
2021-09-07	C4051190	ALLERGY
2021-05-25	C3775529	ALLERGY
2021-03-30	C3631787	ALLERGY
2021-01-25	C3469910	ALLERGY
2020-12-09	C3359630	ALLERGY
2020-11-09	C3285187	ALLERGY
2020-07-29	C3264507	DESEXING-COMPLICATIONS
2020-06-01	C3264507	ALLERGY
2020-04-09	C3254087	ALLERGY
2020-03-23	C3254041	ALLERGY

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

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_consultation-revisit	60.00	2026-02-13	—
20000	tstarc_diagnostic_test_-_cytology	44.00	2026-02-13	—
30000	tstarc_ear_medication_-_antibacterial_and_anti-fungal	108.20	2026-02-13	—

UPM+

DG00676EAR (AURAL) INFECTIONDSTP_otitis_externa

Variant (sleepy_king)

OTITIS EXTERNA

DSTP_otitis_externa

Conf: 0.860

Threshold: 0.07

Above: ✓

Correct?

Yes No