C09997155 / invoice 10000

Reason: R/VAppointment Notes: Wookie (Dog) - Skin Problem [Veterinarian : 1 Consult(No Preference)] - Skin condition not improving despite medicationWeb BookingClient name: Deborah RichardsContact number: 0408314035Email address: drichards415@gmail.comPatient name: Wookie Original Appointment Type: Skin ProblemHistory:  Ongoing skin issues - started on itraconazole last month no improvement as per o - has been on daily almost 14 days now Also on apoquel 16mg SIDMalaseb/aloveen - weekly Neocort ‘Diet - hills sensitive skin no improvement Examine: Fur very dry, +++ scaling throughout Several scabbed areas and patchy alopecia Minimal pruritus noted in consult Yeasty smell imprvoed since last visit Laboratory: Skin scotch tape and skin scrape - majority loose epithelial cells no bacteria, only one or two malassezia Assessment: Malassezia controlled no evidence of pyoderma Recommend reduce malaseb frequency as can be drying, increase use of aloveen Finish remaining itraconazole then stopPlan: Consider bloods to rule out underlying issues eg liver disease + referral to dermatologist - Townsville (provided o with contact details)Recommend adding omega 3 and essential fatty acids to diet or as spot on tx - recommend dermascent essential 6 Recheck INI over next couple of weeks for bloods    Vital Signs    Weight: 34;       

Reason: Nail TrimAppointment Notes: fyl  ------- Sms reply: Yes    Vital Signs    

Reason: Skin Flared Up Again. Needing More Sporanox. Appointment Notes: BMHistory:Last seen Dec 2025 for skin - apoquel 16mg SID and sporanox 100mg SID 21d O has tried reducing apoquel to half tab but not working so back to 1 tab SID Malaseb every 2 weeks Skin much improved fur grown back but just starting to become flaky again so o wants to catch before hair loss again Examine:BARBCS 5/9MM pink CRT 1s Teeth cleanHR + ausc WNL RR, resp sounds + effort WNLAbd palp NADPalpable LNs WNL Eyes NAD Ears NAD Skin/coat - mild flaking throughout coat very mild erythema ventrum and dorsal paws Musculoskeletal NAD Neurological NADPlan:Discussed recommend continue apoquel 16mg SID throughout wet season then can trial reducing againRecommend either weekly malaseb or alternate one week malaseb one week aloveen Trial pulse therapy itraconazole - 2 consecutive days weekly ongoing - can increase to daily for 1 week at a time if needed - script on file Neocort for skin lesions - o has at home    Vital Signs    Weight: 33.2;