C10002938 / invoice 10000

Reason: RecheckAppointment Notes: $113 taken  ------- Sms reply: Yes  ------- Sms reply: YesDr Cameron FayMarrickville AMS Veterinary HospitalDear Cameron and colleagues,Anna Maybury presented Vimto for a recheck dermatology consultation and a copy of the discharge letter is included for your records. With the arrival of “Kit” their two year old son, life has been busy and Vimto has slipped under the radar. We shall get her back on track.  If you have any questions regarding this or other dermatology related cases, please do not hesitate to call us. Regards,  Dr Beth McDonald BVSc (Hons) MVS MANZCVs, DACVD Specialist in Veterinary DermatologyAnna Maybury1/23 Jeffrey StreetCanterbury, NSW, 21939th March 2026Dear Anna and Chris,You presented Vimto today for a recheck dermatology consultation.  It has been some time since I last examined Vimto. You stopped immunotherapy as it was making no difference.  She has been on 4mg of Apoquel once to twice daily but has a strong odour, is very itch and has a very greasy coat. On examination the coat along the back line is greasy and the underlying skin is inflamed. The ears were not inflamed or waxy today. All paws were inflamed and salivary stained.  There were papules and pustules present on her ventral abdomen.Microscopic examination from samples from the paws revealed a yeast infection. Bacterial cocci were present within the pustules on the abdomen. I have run a blood test to check for general health and shall call you within a week with the results.I am discharging Vimto on medication to control his infections and also with a script for a drug called cyclosporine. This drug is registered for the use in dogs with allergies and stops itch as well as reduces inflammation. A common initial side effect is vomiting, but this is controlled by giving the capsule frozen. I shall begin on a low dose first.I have written a script for you to fill at any human or veterinary pharmacy.  The human version, Neoral is identical to the veterinary formulation – Atopica. I do not use generic or compounded products. Some clients find Chemist Warehouse the most economic.It will take 1 – 2 months to take full effect. Once dogs are in in remission, we can often reduce the frequency of the cyclosporine to once every 3 to 5 days.Long term side effects include thickening of the gums, viral warts, and urinary infections. To control the yeast infections please give one 33mg Itraconazole capsule once daily with food for three weeks.To control the bacterial infections, give half a 300mg cephalexin antibiotic tablet twice daily with food for two weeks.Apply a daily leave on rinse or spray of Chlorhexidine 5% solution diluted one part to two parts water. Spray or rinse this over his body every day for three weeks, do not rinse off.Continue to shampoo him weekly in either Malaseb or Pyohex.I wish to recheck him in two months However, I would appreciate a call or email in two weeks to report progress. Of course, if you have any questions or concerns, please do not hesitate to call me.Regards,Dr Beth McDonald BVSc (Hons) MVS MANZCVs, DACVD Specialist in Veterinary DermatologyRhonda ForemanDermatology Technician    Vital Signs    Weight: 7.8;