C09983502 / invoice 10000

Reason: RecheckAppointment Notes: Overdue reminders  ------- Sms reply: YHistory: Grace:Patient Information: - Species: Dog - Sex: Female - Date: 04/03/2026Subjective: - Recheck for skin condition. Owner reports significant improvement with less licking and irritation after a course of tablets, which were finished today. The issue is mainly on the hindquarters/ perineum The dog is otherwise well, with normal appetite, thirst, and toileting. Stools are slightly firmer. - History of similar skin issues, potentially seasonal.Objective: - Cardiac auscultation is unremarkable for her age. - Ears appear comfortable on examination. - Skin on the caudal perineum shows signs of an itch-scratch cycle, consistent with an allergic-type reaction.But vastly improvedMeds finished yesterdayAssessment & Plan:1. Allergic Dermatitis - Assessment: Allergic dermatitis, likely secondary to environmental allergens. The condition is currently well-controlled with medication. - Treatment plan: Dispensed 20 anti-itch tablets to be used as needed for flare-ups. Instructed owner to start one tablet daily if scratching, licking, or rubbing recurs. A minimum of a 7-day course is recommended if a flare-up occurs. No recheck is scheduled at this time, but the owner is advised to return if symptoms persist or worsen despite treatment. - Procedures performed or scheduled: A routine vaccination was administered. - Follow-up recommendations: Advised owner to monitor for recurrence of clinical signs. If medication is needed frequently, a re-evaluation will be required to discuss long-term management options.Additional Notes: - Owner education provided: Discussed the chronic, likely allergic nature of the skin condition. Explained the "itch cycle" and the rationale for using medication to break it. Advised on the safety profile of the prescribed tablets and the "as needed" protocol. Confirmed the pet is receiving monthly NexGard Spectra for flea and tick prevention.    Vital Signs