C10002942 / invoice 10000

Reason: ITCHY SKINAppointment Notes: itchy skin getting worseVerified: NoReason: PruritusHistory:Always itching and scratching himselfAlways wanting to be scratched by ownersPushes up against owners for scratchingHas tried different shampoos including Dermcare and Aloveen oatmeal shampoo with no improvementLicking the air randomlyOwner reports he was pruritic before, possibly starting in JanuaryExamination:BAR in consultMMs: pink & moist, CRT < 2secEars: No odour or significant dischargeCardio: no murmur or arrythmiaResp: Lung sounds clear, normal respiratory effortAbdo: comfortable on palpation, no palpable massesIntegument: No secondary infection, no sores visibleLNs: normalAssessment:Pruritus - possible allergies, seasonal allergies, food allergies as differentialsPlan:Cytopoint SCHandout provided regarding pruritus and food allergiesConversation with owner:Discussed that Cytopoint should work within 24-48 hours if effectiveCytopoint lasts approx one monthText reminder will be sent in one month but only needed if still itchingRepeat injections can be given by nurses for up to 12 months if no other issues developIf Cytopoint ineffective, food trial may be consideredHandout provided on pruritus causes and food allergies    Vital Signs    Weight: 11.5;       

O called and said was itchy again, was previously recommended to use telfast 90mg for itch. Said did work but seems to have worn off.Advised can redose with telfast, can give as often as 24hours if needed. O said gave 1.5 60mg tablets but asked if could give 1/2 180mg instead, advised was fine as both equate to 90mg.Advised IF needing daily ongoing long term would recommend bloods 6mthly--- 05/03/2026 09:40:29 BRR: RCSend anti-hist sheet to o - itching is getting worse, booked in for consult next week    Vital Signs    

Reason: Check HX PleaseRequest to forward to SASH Prospect for apptOK to send.--- 16/09/2025 16:48:46 BRR: VKRSent, pictures attached.    Vital Signs