C09996756 / invoice 10000

Pruritis
Verified: YES 

HISTORY
Presenting for: 2-year-old female dog presented for paw chewing that started a couple of weeks ago
Historical Conditions: Previous episodes of pruritic skin disease starting last year, ear issues, ( see Cowes hx)
Diet: Previously fed chicken-based diet, now using quality brands
Skin: Sudden onset of allergic skin disease last year, current paw chewing for approximately 2 weeks, 
Current Meds: Previously treated with Cytopoint with good response

EXA
Integumentary: Skin condition no lesions despite chewing behaviour, no secondary infection present

ASSESSMENT
Allergic skin disease - Environmental allergies likely given seasonal pattern and good response to Cytopoint. 
Food allergy less likely given lack of gastrointestinal symptoms 

PLAN
New Meds/Tx:
- Cytopoint 40mg dose administered today 
Additional Discussion:
- Discussed environmental allergen management through reduced exposure
- Food trial option discussed involving 6-week trial with novel protein (crocodile and tapioca) - would require elimination of all treats and other foods
- Regular bathing of feet recommended to reduce allergen load using mild shampoo
- Seasonal treatment approach discussed - can discontinue Cytopoint during winter months if symptoms resolve
- Desexing quote provided at $980 given patient's size over 30kg
- Some dogs may outgrow allergies, otherwise lifelong management typically required

hx received from Cowes Vet

A/h ingestion of half a nappy approx 1 hr before clinic admission.

Induce emesis with apomorphine

Vomited large volume of food including chewed nappy material.

Metomide s/c