C10017431 / invoice 10000

Reason: Recheck - Jaa CaseAppointment Notes: ------- Sms reply: YESDiagnosis:  Skin allergiesNo response to food trialSubjective: Owner reports: Last week rechallenged with food last week and the same degree of itchAfter cytopoint didnt seem to work Always itchy around ears and face, Has hada  few previous ear infections prev, but noit currently , no preventative plan as yet No gi signs, Sometiems hives Medications:Cytopoint 40mg -4 wsk not overly effectiveDid kins of help previouslyApoquel not notable imrpoved also Added fish poil supp recentlyHad food trial and no change Objective: Pe wnlEats ok cytology negMild eryteham old scabs ventral tummyRets skin okScratching at shoulder 4x in consultAssessment: Pruritis, sometimes with 2nd inf, mainly neck/head, not relaly reposnsobe to apoquel, cytopoint 1.35mg/kg and food trial: allergies vs nervous behaviourTreatment:  Zenrellai trialPlan:Cont fish oilRec nutriderm over oatmeal condRefer to sashFuc +14    Vital Signs    Weight: 31.3;