C10027802 / invoice 10000

Reason: Ears EDAppointment Notes: Overdue remindersSubjective: - Ears bothering her over the last week; last OE in Dec 2025, a bit of a recurrent issue as also has chronic atopy- Androlla was cleaning the ears, signs weren't improving- Not as responsive with last Cytopoint- didn't seem to have an effect as before, still quite pruritic- Also licks vulva; Androlla tries to apply Neocort if Lulu will let her- EDUF normalObjective: - BAR- mm PMG, CRT normal- Lnn normal- Teeth: Grade 1-2 dental disease- Cardiopulmonary exam normal- Skin: NAD- Ears: mild malodour left ear, mild yellowish discharge; right NAD- Vulva: mild erythemaLaboratory: Ear cytology:- Left: +++cocci, ++Malassezia- Right: +cocciAssessment: - Chronic atopy (strongly seasonal)- Bilateral OE (L>>R)Treatment: - Cleaned both ears with 1ml Otoflush- Administered Dermotic 1ml into each earPlan: - Dermotic 1ml into each ear BID for 2 weeks- Trial Apoquel @ 0.43mg/kg BID for 7 days, then SID ongoing (1 month dispensed)- Neocort BID peri-vulval- r/c in 2 weeks to re-assess and decide on maintenance plan, which may also included Elocon SIW + Apoquel/Zenrelia if working well- Discussed potential SE's of Apoquel long-term    Vital Signs    Weight: 8.2;