C10030550 / invoice 10000

Reason: Itchy SkinHistory:Seen in January with Pruritic skin. Started Apoquel 5.4mg  in  January with a good response overall. O reprots patient has become pruritic over past week again. Vaccination: UTD Tick/flea/worming /heartworm: nexgard spectra Current Medications: Nil Allergies: Nil Diet: Physical Examination:Behaviour: BAR Neurological: proprioception and mentation normalEyes: open comfortable no dischargeEars: mild erythemia both ears, no discharge Oral/Teeth: 1/4PLN: No lymphadenopathyRespiratory: normal bronchovesicular soundsCardiovascular: MM pink, moist CRT <2s, regular heart rhythm, no murmurs 128 Abdominal: relaxed, soft, non tender, no masses palpableIntegument: mild erythmia on ventrum, no skin lesions evident Musculoskeletal: No pain or lamenessBCS: 5/9 Urogenital: external appearance normalTemp: 38.5Rectal: NAD  Laboratory: Cytology: not required  Diagnosis: Ddx:  allergic skin disease: parasitic/infectious causes VS food allergy VS atopy/contact allergy/environmental Discussion: allergic skin diseases (parasitic/infection VS Food allergy VS atopy/environmental/contact.Given history of seasonal pruritis, lack of pyoderna and response of apoquel seem very consistent with Atopy. Discussed medication management options with O: prednisolone VS Apoquel VS cytopoint VS OTC antihistamines. Discussed option to continue Apoquel SID or trial cytopoint. O elected to continue Apoquel. O also has small amount dermotic at home. Recommended O apply dermotic BID to  both ears next 3 days then stop. Treatment: Plan:1. Dermotic BID both ears for 3 days. O has at home already 2. Apoquel PO SID 3 review if concerns 13/03/2026 : Dr Michael Valentine BVSc.(Hons), BNgMrs R Grant : Bailey : Dog 9.5kg35.00 x Apoquel 5.4mg Give ONE  tablet twice daily for 5 days Then give ONE tablet ONCE daily ongoing Recheck Due September 2026    Vital Signs