C10022302 / invoice 10000

Appointment Notes: Booked via Petbarn App: 12/03/2026 03:20:56 AM- NEW CLIENT -Booking Type: Skin, Ears, Eyes or LumpsBooking Notes: Ear itchinessHISTORY:  Presenting for investigation of pruritus. The owner reports Coco has been licking his nose and paws. Appetite and toileting are normal. Diet consists of turkey and cooked vegetables. The owner has been cleaning affected areas with warm water and apple cider vinegar.Current meds: noneVaccination: UTD. Received a vaccination last week.Parasite Prevention: Not mentionedPre-existing conditions: noneAccess to toxins eg. Rodenticide: none EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal, no mouth pain, dental score (1-4): not graded- Abdominal: no detectable pain on abdominal palpation- Rectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: Mild erythema on the ventral abdomen. Paws appear inflamed.Lymph Nodes: NSFEyes: NSFDemeanour/Behaviour: not discussed PROBLEM LIST:- Pruritus (licking nose and paws)- Mild ventral abdominal erythema- Inflamed paws DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Suspected allergic dermatitis (seasonal/environmental vs food). DIAGNOSTICS:None ASSESSMENT:Coco presented for pruritus, manifesting as licking the nose and paws. Examination revealed mild erythema on the ventral abdomen and inflamed paws, consistent with allergic skin disease. The underlying cause may be environmental, seasonal, or food-related. Treatment options were discussed with the owner to manage the clinical signs of allergy. TREATMENT:  Apoquel 5.4mg tablets dispensed.- Dose: 1 tablet twice daily for 4 days, then 1 tablet once daily. PLAN:Start Apoquel as prescribed.Re-evaluation recommended in one week to assess response to treatment.Return for a refill if the medication is effective and signs of pruritus recur.Home into owner's care. CLIENT COMMUNICATION:Discussed the likely allergic nature of Coco's skin condition. Explained that pruritus is causing the paw licking and that secondary infections can occur.Discussed various treatment options:- Cytopoint injection: Explained it is a monthly injection costing approximately $180 per dose. May require a course of 3 months.- Prednisolone: Discussed as a cheaper, short-term option but highlighted potential long-term side effects.- Apoquel tablets: Discussed as a trial to manage pruritus with minimal short-term side effects.The owner opted for a trial of Apoquel. The cost for 15 tablets is $59. Dosing schedule was explained. Advised to return in one week for a recheck.    Vital Signs    Weight: 7.9;