C09982672 / invoice 10000

Reason: Meds Review & Bloods (JB)Appointment Notes: Overdue reminders  ------- Sms reply: YHISTORY:  Presented for a medication review for ongoing use of Apoquel. The owner reports good response to treatment, with licking of paws controlled as long as the medication is administered consistently at a dose of half a tablet daily. No other concerns reported.Current meds: Apoquel 16mg half a tablet daily.Vaccination: C5 UTDParasite Prevention: UTD with unknown brandPre-existing conditions: Atopic dermatitis (licking paws) when apoquel stopped.Access to toxins eg. Rodenticide: none EXAMINATION:Body Condition Score: Overweight 6/9.Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal, no mouth pain, dental score (1-4): 0- Abdominal: no detectable pain on abdominal palpation- Rectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: NSFLymph Nodes: NSFEyes: NSFDemeanour/Behaviour: not discussed PROBLEM LIST:- Chronic atopic dermatitis managed with Apoquel.- Overweight body condition. DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Atopic dermatitis. DIAGNOSTICS:Bloods were taken for IDEXX TAHP testing:- Please find attached to the patient record.> Complete Blood Count- Significant findings: To be reviewed. > Biochemistry- Significant findings: To be reviewed. ASSESSMENT: Presented for a medication review while on long-term Apoquel. Clinically well. Examination revealed an overweight body condition. Bloods collected for routine monitoring due to long-term immunomodulatory medication use to assess for any changes, particularly hepatic or immune-related parameters. TREATMENT:  Bloods collected for in-house CBC and biochemistry analysis for chronic using aoquel PLAN:1. Pend and Review blood results.2. Continue Apoquel as directed.3. Discuss weight management plan with owner. Suggest to put on diet/minimise high calories treats- Home into owner's care. CLIENT COMMUNICATION:Discussed the rationale for performing a blood test to monitor for any potential side effects from the long-term use of Apoquel. Also briefly mentioned the patient being overweight. Awaiting blood results for further discussion.Consent has been given by the client to proceed with this treatment  -  Yes    Vital Signs    Weight: 17.8;       HeartRate: 80;       DentalGrade: 0;       RespirationRate: panting;       CRT: 2;       MMColour: pink;       BodyScore: 6;