C10021319 / invoice 30000

Appointment Notes: cytopointSubjective: due for cytopointTreatment:  cytopoint 10mg SCPlan:  bravecto as other dog has fleascytopoint PRN____________________________INSURANCE HXInitial Assessment > cytopoint injectionSuspected cause > allergiesDate of first clinical signs > ongoingAny other conditions / treatments >  no    Vital Signs    

Reason: AME Cytopoint + EarsSubjective: O reports he ears have been a bit itchy for the past couple of weeks. Have been cleaning with sonotix. She has started licking her paws as well DUDE all normal BAR  Objective: MM/CRT/Hydration: p + m, <2, adequate RESP/RR: normal breathing effort GIT/UG: nad Skin/Ears: mild wax in distal canals, TMs intact, cytology clear Healthy coat, no skin lesions M/S: ambulating well Eyes: clear and bright Lymph Nodes: WNLsBCS: 4/9Assessment: allergy flare up  Treatment: cytopoint 10mg sc Plan: cytopoint PRN If ears worsen okay to dispense dermotic/mometomax ultra    Vital Signs    Weight: 7.6;       

REPEAT MEDICATIONSubjective: Itcy flare up despite Cytopoint 10mg SC given 3 weeks ago Due Bravecto. Needing something to get by until next Cytopoint can be given later in the week Treatment: Prednisolone Tablet 5mg + Chlorpheniramine 2mg (Prednil) Please give ONE to TWO tablets ONCE day for 3 days Then HALF a tablet ONCE daily for 3 daysThen HALF a tablet every second day for 2 doses. Then STOP. Plan: Consider Cytopoint 2mg/kg dose range in future vs using low dose Pred for any break-through pruritis.    Vital Signs