C09986144 / invoice 10000

History: O stated her pruritis returned post steroid course. Scratching at ears consistently. O took them both off the chicken, now feeding beef predominately. Passing solid stools. No v+. No chewing of paws Examine: BAR PLR ok Dentition ok Inner ear pinna L ear 2 scratches from self trauma Inner canals clear , TM in tact, no debris at all within canal HR 100 reg, chest ausc NAD Ventral abdo = diffuse pimples Interdigital skin ok BCS 5/9 Assessment: Atopy , other Plan: Recommended cytopoint, o declined due to cost Commence anallergenic diet only , avoid other treats / chews etc --> needs to be on this for 6 weeks minimum , if ineffective then environmental allergy likely so will need to reconsider cytopoint or zenrelia Short tapering course pred    Vital Signs    Weight: 6.5;