C10007425 / invoice 10000

Presented for cytopoint inj
Last one lasted lot longer 

BAR, TPR WNL

Cytopoint 20mg given SC (B806983 exp1226)

HISTORY:
started itching the last few days 
went to O's brothers house who has a grassy place 
noticed itching on mon/tues 
hotspot spray at the pet store used the last few days 

EXAMINATION:
BAR
ventral skin not inflamed 

ASSESSMENT:
atopy allergy well controlled on cytopoint 

PLAN:
20mg cytopoint SC today 
disc flea/worm preventative with O - adv to give this as fleas can contribute to allergy too, O will give nexgard spectra

COMMUNICATION:
plan as above 

HISTORY:
Presented for: cytopoint review appt
Has been going ok
Itching worsens in warmer weather
Now scratching bit less in cold 
Skin seems bit red 
O wipes belly with wipes after walks - dog wipes or other 
Diet - advance chicken, proplan 
No v+ d+ 
F&W: utd with nexgard spectra or other supermarket 

EXAM:
BAR, lovely
HR 120bpm, no m/a
RR 30, lung sounds clear 
Temp not taken
Abdomen soft, comfy
MM pink, crt<2sec
Integ: mild erythematous skin of ventral abdo, inguinal region, axillary, along FLs and HLs 

ASSESSMENT:
Allergic skin dz - ddx contact vs food vs atopy vs parasites vs other

PLAN:
Continue current dose of cytopoint 
Cytpoint 20mg given SC (B782180 exp0726)

COMMUNICATION:
RV in 4-6wks for repeat cytopoint