C09990390 / invoice 10000

Appointment Reason: Recheck , Appointment Notes: ------- Sms reply: YHX- had been on hills adult dog food (which was fine) then had swapped to lamb - has been avoiding wheat - taste of the wild lamb was what he swapped to. was on hills chicken based prior - had the change right before foot flareup - finished pred, still finishing abx PEmentation BAR nice boy but growling at man in reception HR 120 RR pantmm p and m crt <2abdo palp nad L foot mild erythema, tiny scab still presentR foot tiny amnt of erythema no scabbingrest of skin ok a: resolving lick granuloma but still ongoing evidence of pruritis assoc w feetrecent food changed. tx optionspred continued, apoquel, zenrelia, cytopointapoquel BID to begin with then down to sID then EOD weekly intervals swap back to original foodplan INI then consider longer course of apoquel vs swap to zenreliaalso consider formal food trial carol to update in 1- 2weeks     Vital Signs    Weight: 7.8;