C10015352 / invoice 10000

Reason: Ears Skin SSAppointment Notes: Overdue remindersHistory: In for skin issue - reviewing the chronic skin pruritis/recurrent OE etc. EDUF ok. Pruritis/skin issue started around 4 months of age, possible sensitive to chicken, usually worse during humid seasons, but can be non seasonal. Quite pruritic and O feels that cytopoint has not been as effective as before. They were away Jan/Feb and the ears flared up before and when the dog was with the sitter. On bravecto quantum. Has been using elocon on the ears once a week.Examination: Dog QARGrade 1 DDChest clearAbd palpation NADAtopic signs - hyperpigmented, erythema skin around axilla/caudal ventrum bilaterallyL OE erythematous and more sore - stenosis notedR ear mildly erythematous and waxyTreatment: Neptra applied to L earIndepth discussion re atopy/food allergy etcPlan: Pred 20mg 1/2 tab BID for 1 week, then 1/4 tab BID for 4 days, then 1/4 tab SID for 4 daysElocon BIW for R ear for the next few weeksO keen to start elimination diet but may consider proper food trial laterRecheck in 2-3 weeks' time to recheck L ear + discuss plan going forward - considering derm referral    Vital Signs    Weight: 23.2;