C09971666 / invoice 10000
Species:CANINE
Breed:Australian Cobberdog
Age (years):3
Diagnosis or signs:KC Skin Revisit
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div> <p>HISTORY<br>- cytoppoint given in Winch december<br>- licking paws and rubbing cratching at face again <br>- had been doing well with regular grooming, keeping jaw short, paws hsort and ears plucked <br><br>Response to treatment: good - got good response to apoquel also<br>Itch score: curerntly around 7<br>Other concerns: No <br><br><br>SKIN EXAMINATION<br>Skin - LF paw interdigital dermatitis lick staining and moist dermatitis P3/4, and ventrally<br>RH paw - mild interdigital dermatitis ventrally, mild lick stainng<br>- jaw - skin folds moist, no purulent exudate or dermatitis, or brown staining<br>Coat good <br>Ears - mild inflammation, mild ceruminous exudate<br><br>Cytology - both ears have 1+ cocci and yeast<br>LF paw - +++ malasezzia, and scattered cocci<br>RH paw - + malasezzia <br><br><br>ASSESSMENT<br>mild yeast infections skin, and bacterial otitis<br>topicals should be fine but needs cytopooint to help break itch cycle<br>o prefers cytopoint to apoquel due to not feeling he needs ongoing daily medication, prefers the lasting effect of cytopoint<br><br>PLAN<br>Cytopoint 30mg sc<br>dermotic 1ml both ears x 5d then weekly elocon for maintenance<br>malaseb bathing of paws, then apply dermotic - bid x 7-14 d then malaseb/ppyohex conditioner for maintenance<br>Review in 1mth for another cytopoint<br>O thinks moisture contributes and will be pretty wet for next few months most likely<br>"</p> </div></html>
Animal clinical history (3 most recent)
2025-08-26T00:00:00Z 11:14:00
Hx:presented for licking at paws and scratching at ears over weekendskin has been good after having regular grooming, been off cytopoint and apoquelnot used elocon past few weeksotherwise well, EDUF normalEx:BARBCS: 5/9MM: pink, moist CRT<2TEMP:CVS: HR ,no murmur or arrythmia auscultated, SSFPRESP: RR , clear bronchovesicular lung sounds, normal effort/rate.OCULAR: nsfORAL: G1/4EARS: bilateral erythema and dark brown cerumen dischargeLN: nsfABDO: soft, comfortable.MSK: no lameness observed, comfortable on examNEURO: nsfUROGEN: nsfINTEG: mild interdigital erythemaAx: atopyOEPx:Discussed apoquel vs cytopoint for ongoing management - O elect apoquel. will start with labelled dose 10.8mg BID, can trial 1/2 16mg if getting repeat to see if effective as more economical long termTx:apoquel 10.8mg BID SIDdermotic 1ml BID 10delocon 1ml once weekly
2025-04-14T00:00:00Z 11:51:00
HISTORY- had an ear infection - resolved well- started dermotic again a week ago - twice daily - responded well but needs another bottle- paws have been good- face flared up - scratching jaw again- has been on apoquel - was going well on it - was fine for a while on eod dosing and then O moved and his doses were forgotten and this may have been when ears flared up again.- O worries about forgetting to treat with apoquel and then flaring up again so wondering if cytopoint + ear steroid would be better as his ear was the only residual issue without the cytoResponse to treatment: reasonableItch score: 4/10Other concerns: none, EDDU well, is on wild boar prime 100 and a lamb based kibble - Glow brand as Prime too $$SKIN EXAMINATIONSkin - feet, belly very calm, no lesions; chin - mild inflammation, no lumps or soresCoat goodEars -clean and clear on otoscopic examCytology - ears - clean and clear both earschin - ++ cocci, occ neutsASSESSMENTmild bacterial overgrowth/pyoderma chinunderlying allergic dermatitis - most likely atopicPLAN- start mometasone tx for ears biw - Sat and Sun 0.6ml- cephalexin 500mg po bid x 10d for chin- chlorhex wipes 2% sid on chin x 14d - purchase Nootie chlorhex/miconazole wipes for ongoing use- use apoquel if needed for flares- rx more dermotic for early tx of ear infection if relapses"
2025-02-24T00:00:00Z 10:20:00
Skin looking pretty good- though R ear and fore paw started to flare on the apoquel - on days when they forgot to give it - but still whilst on the 2 BID dose.Discussed difficulty with food trial as very picky starves himself then gets aggressive with the kids.Interdigital skin settling nicely with malaseb bathing and conditioner. No further tx for that - continue with topical bathing.OE - brown - Cytol ++ malasezzia - Dermotic BID 0.7mls 2 weeks then revisit for swab and pulse elocon.Gave detains for MSVC for dermatology consult. Discussed allergy testign etc.Refill apoquel - have 2 d off whilst dermotic started up then recommence
Previous claim history (8)
| Date | Claim # | Diagnosis |
|---|---|---|
| 2025-04-14 | C8583765 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-02-24 | C8370542 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-02-12 | C8320240 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-01-13 | C8188748 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2024-12-12 | C8065471 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2024-11-27 | C7999987 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2024-08-01 | C7531196 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2024-03-22 | C7032683 | EAR INFECTION |
Line items(lines with upstream diagnosis are skipped by the model)
| Line | tstarc | Amount | Date | Upstream diagnosis |
|---|---|---|---|---|
| 10000 | tstarc_consultation | 105.00 | 2026-03-02 | — |
| 20000 | tstarc_skin_medication_-_cytopoint | 234.99 | 2026-03-02 | — |
| 30000 | tstarc_ear_medication_-_antibacterial_and_anti-fungal | 89.97 | 2026-03-02 | — |
| 40000 | tstarc_diagnostic_test_-_cytology | 49.50 | 2026-03-02 | — |
| 50000 | tstarc_elizabethan_(buster)_collar | 29.22 | 2026-03-02 | — |
UPM+
- DG02339HYPERSENSITIVITY DISORDER (ALLERGY)DSTP_skin_-_allergic_disorder
Variant (sleepy_king)
HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.430
Threshold: 0.38
Above: ✓
Correct?