C10006419 / invoice 10000

Reason: CytopointAppointment Notes: 35.8kgPresenting Complaint:Hx: Current Meds: cytopoint every 4 weeks. PE:    Despite cytopoint every 4 weeks, skin is not well controlled. Large amount of perianal hair loss, bits of hair loss lateral feet, also periocular hair loss. Owner describes the itch as improved in cytopoint but bever controlled, always itchy. Has malaseb washes.Discussed and advised swapping to zenrelia and aiming for a 3 month zenrelia trial. Have taken a photo of hair loss around bottom today to compare to .     Problem List: DDx:Tx/Plan: Zenrelia dose - have ordered 15mg tablets x 90 - Dose 1.5 tablets once daily ongoing. Need to charge onto account and recheck in 6 weeks to assess repsonse.Dx:Client Communications:Follow-up:    Vital Signs    Weight: 35.8;