C10004655 / invoice 20000

09-03-2026 9:54:53am
Dr Ellie J Waters

Recheck ears apt.

OR that Kai is much more calm. Stopped giving gaba/traz a few days after appointment. Still giving cephalhexin, macrolone and apoquel as prescribed. Seems much more comfortable in himself. Not bothering at ears at all.

Sedated with 0.6ml medetomidine (0.025mg/kg) PO when o arrived for appointment

Mild sedation achieved, enough to get muzzle on. As soon as tried to examine ears, became much more awake.

EW discussed with o that likely needs injectable sedation - got o permission to sedate IM.

IM sedation given @ 9:56am
Medetomidine - 0.008mg/kg (0.2ml) IM + Butorphanol 0.08mg/kg (0.2ml) IM + 0.4ml Alfaxan IM

Marked sedation achieved. Looked down ear canal and swabbed both ears. Monitored throughout (HR, MM, Pulses)

Otoscopic examination revealed:

Mild ceruminous discharge, that of a healthy ear
Mildly inflamed ear canals.
Unable to examine tympanic membrane - ear canals ever so slightly too stenotic.
Cytology revealed very very mild yeast and cocci. No rods seen.

Given clinically improved and minimal infectious agents in ear, as well as inability to visualise the ear drum, adv no need for topical ear drugs today. Adv continue on with preds EOD and continue long term apoquel.

Given 0.6ml atipamezole IM @ 11:10am

Becoming wakier in consultation. Eyes open, slightly lifting head.

Walked out of consultation 11:20am.

Discussed post sedation care and given discharge instructions. Adv that we have reversed the medetomidinee, but the other drugs will still be in his system for 4-6 hours

Discussed behaviour - O stopped gaba/traz a few days after last hospital appointment. Overall, o thinks that behaviour has been much better since skin started clearing up. Adv that Kai is certainly showing signs of anxiety still, and ongoing training and possibly medical management may be necessary to ensure his welfare.

PLAN
Continue long term apoquel
O to call as soon as any ear irritation signs develop
Ringing in two weeks for an update on skin and behaviour