C10018795 / invoice 10000

Appointment Notes:  Promnitz promnitz@optusnet.com.au 0419227986- Bear (Dog) - Skin/Ear Consultation [Veterinarian : Jane Cochran(No Preference)] - skin allergy and ear infectionWeb BookingClient name: Roger PromnitzContact number: 0419227986Email address: promnitz@optusnet.com.auPatient name: Bear Original Appointment Type: Skin/Ear ConsultationHistory: Bought in by Roger. Bear and Teddy are from same litter. Over last 12 months both dogs have had dermatitis and ear infections. O feels Bear more severely affected than Teddy. Using apoquel but with Bear as soon as they stopo he gets itchy again within 1 day.Diet is Lykka- mix of different proteins. Otherwise well.Examine: BAR, mm pink, teeth ok. Thorax nad, abdo nad. Skin down anterior aspect forelimbs is hypertrophied, hair is thinned, also caudal aspect carpi similarly affected. Bilateral otitis externa - right ear worse. In house cyto- yeast ++++++.Assessment: atopic dermatitis and otitis most likely.Spent alot of time discussing the disease and causes, potential work up and management.Explained likely to be life long management. May be worth trying to identify a trigger.Need to see if we can better lon term management.Discussed food allergyEnvironmentalFood trial skin testing, referral etcPlan: wash in Malaseb or Mediderm shampoo weekly.Transition to 1/2x Zenrelia 8.5mg tablet orally once daily. (Supply prescription to help manage costs).Cleaned ears with epiotic SISEasotic both ears sid.Rv in 1 week to asses progress.Recommend changing to the Lykka goat diet as a novel protein diet and see if this helps us manage the condition.R IGHT ERARAXILLA/ CAUDAL FORELIMBS- HAIR LOSS.Script for medicationFOR ANIMAL TREATMENT ONLYPATIENT:	BearDOB:		31/10/2021OWNER:	Mr & Ms R&B Promnitz34 Merrenburn Avenue , Naremburn, NSW 2065DATE		11/03/2026Rx		Zenrelia 8.5mg tablets x 90Mitte		Give ½ tablet orally once daily when itchyRepeat x 2_____________________________________________ Dr. Jane Cochran BVSc MVS NSW V5732For Crows Nest Animal Hospital.    Vital Signs    Weight: 5.1;