Patient: Bella — Labrador Retriever, FS, ~2y (DOB 05-23-23), 34.40 kg (05-06-25).

Allergy/derm timeline (the headline):

• 11-08-23: First otitis externa, bilateral. Treated with Claro x2.
• 12-06-23: Otitis resolved on recheck.
• 02-16-24: Recurrent otitis — treated with Claro.
• 06-28-24: Recurrent OE (AS) + multifocal pink foci ventral abdomen/inguinal + erythema/hair loss palpebral margins. Started Apoquel BID, Claro AS.
• 09-04-24: Atopy suspected — head shaking, dry skin around eyes, hair loss, groin redness. Started Pro Otic HC.
• 10-09-24: Annual exam — mixed otitis externa AU (3+ yeast L; 3+ yeast/2+ cocci/1+ WBC R). Rx Otizole. Pustules in inguinal region. Strongly suspected food and/or atopic allergy.
• 01-09-25 — 01-17-25: Owner pursuing dermatology referral; tech and Dr. Smith recommended food trial first (Derm Complete or HP) plus serum + intradermal testing. Email sent to client; LMOM 01-17-25.
• 02-11-25: Atopy diagnosis. Refilled Apoquel. Hair sample test (Five Sense) reportedly showed severe cat dandruff allergy + many others.
• 04-14-25: Flare — moist neck lesions, axillary alopecia, inguinal erythema, "yeasty" odor. Cytology: 2+ yeast/3+ cocci groin; rare yeast/4+ cocci/1 rod? L axilla; 4+ yeast/3+ cocci neck. Started Ketoconazole 200mg x 21d, Simplicef 200mg x 10d, ProHex shampoo 1–2x/wk.
• 05-06-25 to 05-07-25: Recheck cytology — improving but not cleared. Continued Simplicef + Ketoconazole another week (additional 7 of each filled 05-08 to 05-14).

Currently on / recently used:

• Apoquel 16 mg PRN
• Ketoconazole 200 mg (most recent 7-tab written Rx 05-08-25)
• Simplicef 200 mg (most recent 7 tabs 05-14-25)
• ProHex 2% shampoo
• Nexgard Spectra XL — last dispensed 5 months 07-11-24 (Jul–Nov), likely lapsed

Vaccines (last given 10-09-24):

• Rabies 3-yr (#15814017) — current
• DA2PP 3-yr — current
• Lepto annual — due ~10-2025
• Bordetella IN — due ~10-2025

Open threads to ask about today:

• Any repeat taping done since 05-07-25?
• How is the itch/skin/odor since finishing the second antibiotic/antifungal course?
• Heartworm/flea-tick prevention status for this season — last dose ~Nov 2024.