C10007554 / invoice 10000

Appointment Notes: Paws App Details:Booking Type: Cytopoint InjectionBooking Vet: - Any -Booking Notes: Night need to discuss other optionsOwner Is your pet(s) insured?: YesHistory: Has noticed the last 5-6months the cytopoint is not workign as effectively as before Due for 6 month check for cytopoint Licking at dorsal aspect of the FLs and slightly at her paw pads Examine: BARMedial aspect of FLs no abnormalities of skinMild erythema of all paws FL > HLs - lick staining present Mild erythema of inguinal region LHS> RHSNo erythema of ears but mild aural discharge Assessment: Discussed options for allergies 1. Increase cytopoint and trial 20mg although not registered - not always but when itch is worse possibly2. Trial apoquel - O said not feasible as she is not always home and other people at home cannot tablet her3. Pred when itch is significantly worse - did not want to use steroids4. Refer for intradermal testing with dermatologist and immunotherapy - felt this was too much O did not like any of the options and have decided to go ahead with the 10mg cytopoint for now Treatment: Cytopoint 10mg given sc interscapular --- 02/03/2026 17:08:44 AF:O frustrated in paying additional $103 for vet time when did not get further treatment/only had a cyto injectin. MM    Vital Signs    Weight: 6.9;