C09971857 / invoice 10000

Appointment Notes:  Tolmatsova anastasia.tolmatsova@gmail.com 0478868903- Archie (Dog) - Recheck [Veterinarian : Britt-Louise Karlsson(No Preference)] - The symptoms persist after cytopoint injection a week agoWeb BookingClient name: Anastasia TolmatsovaContact number: 0478868903Email address: anastasia.tolmatsova@gmail.comPatient name: ArchieHistory:Brought in by MsHas not improved with the cytopoint this time. Normally improved with the injectionsDoes go between houses and spends one week with Ms and other walk with ex partner, not sure if he has been walked in a different area than normal.Is fed crocodile, kangaroo, duck etc but is fussy eater. Stays awya from chicken and beef. O not sure if he gets treats etc when he is at ex partner.Has had antihistamines in the past but O feels he is too itchy for them to work this time. FTW - UTDVaccinations - UTDExamination: BAR - nervousBCS: 4/9Vitals wnlEyes/ears/nose; L ear a few cocci, no yeast - light brown/yellow minimal amount on swabR ear normalSmall amount of clear discharge from eyes, conjunctiva normalSkin: ventral abdomen erythema, small patch of red flaky skin at sternumFeet: mild erythema between foot pads, nailbeds OKAssessment:Atopic and food allergiesNegative for OE on swabs - may just be sore due to allergyDiscussed with O he may need more treatment now and then when have severe flare ups. Can add in apoquel as pulse therapy when neededDiscussed the negative swabs for the ears and offered ear treatment as prophylaxis in case he has a starting ear infection, O would rather wait and see if it resolves with apoquel. Treatment:Apoquel 5.4 mg SID or BID or BID if neededNeocort on the red patch on sternum BIDPlan:Re-check INI or of ears continue to be irritating him    Vital Signs