C10006147 / invoice 10000

Appointment Notes: ConsultationVETSTORIA - Louis (Dog) - John Bakouris - 0409041724 - Consultation [Clinician : Dr Maddie Beikoff(No Preference)] - His left front paw . Constant licking . Very red . (New client) No, this is not an emergency. Web BookingClient name: John BakourisContact number: 0409041724Email address: jbakouris@hotmail.comPatient name: LouisHISTORY:Owner reports that Louis has been licking feet non-stop, particularly LFL. Adopted a few months ago - John's partner is a GP and Louis came from an elderly patient who was unable to care from him. No other health issues or concerns Flea/tick/worming: UTD PHYSICAL EXAM: Demeanour: BARVitals: WNL CVS: regular rhythm, no murmur, SSFP.RESP: normal respiratory effort, clear bronchovesicular sounds; no crackles or wheezes.ORAL: NAD OCULAR: NAD, moderate tear stainingEARS: NAD ABDO: soft and comfortable to palpate.LNs: peripheral LN WNL.INTEG: coat clean, no visible ectoparasites. moderate interdigital erythema and licking staining on all paws, moderate erythema ventral abdomen and chest GAIT: ambulating well, no lameness observed.UROGEN: NADASSESSMENT: Likely contact allergy, atopy, food, other PLAN: Discussed topical steroids vs steroids vs apoquel/cytopoint. Recommend latter option for reduced side effects, O keen to trial apoquel. Gave a months worth but can have more for next 6 months if going well Malaseb shampoo w/ 10 minutes contact time on paws and other affected areasRV INI or getting worse     Vital Signs    Weight: 4.5;       MMColour: Pink;       RespirationRate: 24;       HeartRate: 120;       Temperature: 38;       BodyScore: 5;       CRT: 1-2;