C10004538 / invoice 10000

07/03/2026 Walk in consultation for itchiness around perineum and ventrum. Getting Apoquel as needed for skin irritation. Last dose was two days ago and prior to that 4 days about 3 weeks ago. No significant ear irritation. Also due for iw medication. O is giving Bravecto topspot for flea/tick prevention. Normal appetite, thirst and toileting.
PE: Erythema of ventrum with scattered macules. Axilla, ventral chest and groin affected. Erythema of perineum. Mild muzzle erythema. Ears normal on swabbing and examination. Eyes, LN, hrt/lng snds, abdo palp, skin, coat normal. HR108, reg. BCS 5/9. Expressed mild ags. Left impacted so initially difficult to express.
Tx: Needs more regular and consistent allergy management. To have daily tx for 3wks then if itch well controlled give weekdays for two weeks then gradually reduce. Also discuss a food trial as o feels gets worse with certain foods. O will consider. Recommend either commercial or home prepared diet for trial for 6-12 wks. 
To apply neocort to inflamed skin and monitor for sores or crusts developing. Return for oral ab if needed. Dispensed more Apoquel as o is running low on supply at home.
Gave iw tablets.