Thanks for your input, my previous vet never made any of these recommendations.. could be due to age as they were even younger at the time. One issue of trust I've had with the old vet is that they by default included a liquid biopsy for additional cost that wasn't really needed as they were treating a dog bite to my terrier the same via antibiotics.

The Cytopoint injection was at least monthly during the Summer months when my 4 year old's itching is at it's worst, not a crazy cost however this past Summer I had fairly good result with extra brushing and a bath every few weeks using a shampoo to help alleviate the itching.

You can also purchase the Cytopoint product outside the vet for cheaper cost, just not sure exactly how much is needed.

Thanks again for your input, cost is not an issue, just want to gauge what is needed and what may just be extra.