C10028649 / invoice 10000

Reason: Cushings ReviewAppointment Notes: Overdue reminders  ------- Sms reply: YWeaning off pred to recheck ACTH in one months time. Has been itching paws a lot and panting. Was doing well on cytopoint but doesn't seem to work since last year. To help with the itching - consider starting on Apoquel 5.4mg loading dose (1 tab BID for 2 weeks then 1 tab SID ongoing) Twice weekly shampoos Examine:BAREyes, Ears and nose NAD Dental grade 2/4, pink MM, 1 secHeart and lung ausc - wnl Comfortable with abdo palp. Lichenified skin around inguinal region and under armpits BCS 7/9 Treatment:Apoquel 5.4mg Plan:After 3-weeks wash out period off pred --> ACTH stimulation test Trazodone prior to groom    Vital Signs    Weight: 11.5;