C10007081 / invoice 10000

Appointment Reason: Revisit, Appointment Notes: Levi (Dog) - Revisit [Veterinarian : Dr. Grace Hutchison (Preferred Clinician)] - Itchiness - elimination diet did not work - Web BookingClient name: Erwin MacarioContact number: 0468865688Email address: macario.ea@gmail.comPatient name: Levi Original Appointment Type: RevisitIn with ErwinStill fairly itchy, licks and chews on medial aspect of hind limbs, and front of paws, and behind ears. History:Has been on Royal Canin Anallergenic for 7 weeks Seemed to get better for about a week or two, while using the steroid cream, then has gone back to scratching Seems to get worse after running around at the dog park, so possibly grass related Main areas - biting his back ankles 70%, 20% front paws, 10% scratching behind his ears Wiping down his ankles daily Using the cone at night and a small dab of steroid cream Objective:BAR Eyes/ears/nose - nad, no discharge or erythema MMs pink and moist, CRT<2Skin - mild erythema ventral abdomen, patches of alopecia hocks Diff quick tape prep - negative Assessment:Pruritis No improvement after diet trial Plan:Owners are keen for referral to dermatologist - gave info for MVSC Derm team Opted to start Apoquel in the meantime - opted for script - Apoquel 3.6mg     Vital Signs    Weight: 8.76;