C10008358 / invoice 10000

PRESENTATION: C7 & Annual Health Check

HISTORY: Still pruritic even on apoquel. Teeth brushing regularly. Only chews paws, has always been the case since she was young. 
EDUD normally, nil V+ or D+
Current medications: 1.5 tab apoquel SID
Diet: carrot and blueberries for breakfast, raw 4paws (turkey) 

EXAMINATION:
Demeanour- BAR, FAS 2-3, loves liver treats!
Cardiovascular- NAD
Respiratory- NAD
Neurological- NAD
Musculoskeletal- NAD
Lymph Nodes- NAD
Gastrointestinal- NAD, very tense
Genitourinary- NAD, hooded vulva, BCS 7/9
Integument- lichenification, erythema and saliva staining primarily at axillary region (symmetrical), also mild erythema both FL paws
Oral- 1/4 PD
Eyes-  NAD
Ears-  NAD
Rectal- Full AG bilateral (has had scooting in the past but not currently scooting, Owners just smell it sometimes) - expressed, normal contents, comfortable.

PROBLEM LIST:
Atopy flare up
Due for C7 and milbemax
Hooded vulva
Full AG
Overweight

DIAGNOSTIC EXAMINATION:
Cytology (acetate ) of axilla and paws - malazzezia ++ both regions

ASSESSMENT: Fit to vaccinate. PVAS around 5/10, apoquel not sufficient as infection present - treat malazzezia infection with prednisolone and daktarin, then back to qpoquel for maintenance. Stools normal, monitor AG scooting, nil intervention today.

TREATMENT: Daktarin SID 7 days then once weekly on affected areas
Pred 0.5mg/gk BID 7 days then SID 7 days
C7 s/c

PLAN: recheck skin in 10-14 days then continue apoquel if infection cleared.

RECOMMENDATIONS:

Next visit booked: (N)

MEDICATIONS DISPENSED: Apoquel 5.4mg

Drug (Shelf) Name: Apoquel 5.4mg
Volume/Number: 100
Label (Instructions): Give 1 tablet every 24 hours (once daily)

Prescribing vet: AG
Revisit due:  March 2026

MEDICATIONS DISPENSED: Apoquel 5.4mg

Drug (Shelf) Name: Apoquel 5.4mg
Volume/Number: 100
Label (Instructions): Give 1 tablet every 24 hours (once daily)

Prescribing vet: LC
Revisit due:  March 2026