C10028564 / invoice 10000

Recheck -  OR still pruritic/ head shaking On Ce, right ear, completely clear, see all the way to TM, no erythema. Looks greatDisc with o maintenance now:1. For 1 week every day use cleaner and then steroid - disc can apply 0.5ml into ear daily. After 1 week reduce to EOD, twice a week etc until on the lowest level that prevents the ithcAim to clean once every 2 weeksIf start with head shaking use daily for 3 days, if continue reex, if no can stop again2. Continue wth apoquel, increase in flares, can try to stop if management of ears with topical alone is sufficient3. O going to try purina hydrolysed diet - disc strict. At end of diet can stop apoquel and monitor response. If works then add in indivudal proteins, if no different unlikely food related. Adv o recheck if concerns/ questions. O happy with plan    Vital Signs