C10002678 / invoice 10000

Appointment Reason: 1.4 CONSULT 4, Appointment Notes: C5 GL  ------- Sms reply: YVet MKPresents for annual vaccinations and check of skin lesionsHas had on/off skin issues in the past - has been on cytopoint/apoquel beforeOR skin lesions have come up in the last couple of weeksNo change in environmentPE: TPR normal BAR, nice dogEENT - No discharges or obvious lesions in ears or eyes, no significant oral disease.  LN -  External lymph nodes palpably normal - submandibular, prescapular, inguinal, popliteal RESP -  Normal bronchovesicular sounds, normal effort CVS - SSFP, no murmurs or arrhythmias auscultated ABDO - Abdominal palpation normal PERINEUM - No discharge or lesions noted in anal gland area. Rectal examination not performed today INTEG - *** Multifocal epidermal collarettes with alopecia on flank and ventrum 6 in total. Visibly pruritic in consultMUSCULO - Normal gait, no lameness identified, no obvious pain or joint swelling found UROGEN: No abnormalities on examination of genitals NEURO - Normal mentation. CNs intact, CP normal, pain response present, reflexes normal ASSESSMENT/ABNORMAL FINDINGS: PruritusSuperficial pyodermaOtherwise in good general healthProtech C4 SQ + Protech BB IOProheart SR 12 SQBravecto Quantum SQDiscussed preventative options with O - opted to switch to all yearly injectionsCommence apoquel 0.4mg/kg PO BID for skin + malaseb bath twice a week    Vital Signs    Weight: 20.6;