C09971768 / invoice 10000

Reason: Skin / InfectionAppointment Notes: Booked Online: 28/02/2026 20:15:49 PMBooking Type: Skin, Ears, Eyes or LumpsBooking Notes: Skin infectionHistory: Louis is a 5 year and 4 month old male neutered French Bulldog presenting for skin rash. O reports that Louis has been Has had bad reaction to cephalexin in past, has had metronidazole for somethign else which was fine for gut Yeast infection had ketoconazole  Pregabalin, pred now every 3 days same dose And apoquel AmoxyclavNo ketoconazole in stock, could o script for compounding pharmaxcy (or online pet chemist) or could do itraconazole prev vet reccMth ago got cortavance for scabbed skin lesion had before, seemed to help but O thinks maybe yeast or bacterial skin infection, new lesions 3x around body, O thinks something stronger, on meds for IVDDIf it is yeast infection O knows med that works well for himOn abdomen R almost inguinal over the weekend, RHL thigh back same as last month got better but now bigger, LFL cranial 1wk ago pink raised lump aalmost Has been licking occasionally  Tape prep Could add austrazole? 1mth ago sent home with malaseb and cortavance for lesion pustular - any improvement? Stil=l been on apoquel? Could increase to BID for 1-2wks if needed (but also on pred), or could change to zenrelia more targeted antiallergy medication Bathed weekly with malaseb again? 10 mins? helps?Cytopoint didn't helpGI upset from ABs in past - also from antifungals? Ketoconazole dispensed, recc to give hgalf tab for 3 weeks - did you do that? Any improvement? Any left? Could trial3x surgeries for patella issue, MPL sx bilaterally 2022, spine issuesDermatologist visit in November 2022, owner declined allergy testing - would you be open to another consult? Poss for intradermal allergy testing + desensitisation injs Diet? Recc hypo/anallergenic? Current meds: Prednisolone 5mg daily (recently reduced from 10mg), pregabalin 75mg daily, and Apoquel 4mg (1/4 of a 16mg tablet) daily.conditions: Inflammatory Bowel Disease (IBD), allergic skin disease, Medial Patellar Luxation (surgically corrected), spinal abnormalities (hemivertebra).spot wash the affected area daily with Malaseb shampoo, leaving it on for 10 minutes before rinsing.Prescribed Cortavance spray to be applied to the lesion once daily after washing. Advised to apply with cotton wool if he dislikes the spray.Advised to manage the ocular discharge with a lubricant eye drop (e.g., Kylfort [?]) from a chemist, to be used twice daily or as needed to flush out allergens.skin infection likely caused by overgrowth of normal skin bacteria (Staphylococcus) due to underlying allergies and inflammation. use of prednisolone and Apoquel suppresses the immune system, which can make him more prone to such infections. treat the lesion topically with medicated shampoo and a steroid spray. Advised on managing the eye discharge with lubricating drops to flush out allergens, avoiding steroid eye drops unless symptoms worsen significantly. Diet + appetite: eating and drinking well Urination/defecation: normalPreventatives: UTDAny issues: no other concerns Examination: Demeanour: BARHeart: 100Resp: 30BCS: 5/9MM: p+m, CRT <2Mouth: C1G0, normal occlusion, no cleft palate MSK: able to ambulate well, normal gaitNeuro: normal mentation, no obvious cranial nerve deficits or ataxiaEyes: clear, normal menace response and palpebral reflex, responds to visual cuesEars: no erythema or lesions, not painful or warm on palpationAbdo: no pain on palpationInteg: focal, wet, pustular lesion is present. The owner reports it was previously pinker. On the caudal aspect of the right hind leg mid thighLaboratory: Sticky tape impression cytology Ear cytologyAssessment: Pruritis ddx - parasites (fleas, mites), dermatophytosis, food allergy, contact allergy, atopy, bacterial/fungal secondary infection1. Focal moist pyoderma: a focal staphylococcal infection is suspected secondary to underlying allergic skin disease.2. Mild mucoid ocular discharge: likely secondary to allergic conjunctivitis.- Focal superficial pyoderma likely secondary to allergic skin disease.- Mild allergic conjunctivitis.- Immune suppression from prednisolone and Apoquel may increase susceptibility to infection.Treatment: Cytopoint inj (once a month or PRN)Apoquel tabs (daily)Malaseb/Aloveen shampoo + conditioner Apex antibiotic creamConsent has been given by the client to proceed with this treatment  -  YesPlan:O to monitor, revisit if concernedReason: Nurse: -vaccination -heartworm -worming -flea/ticks Exam: Lab: Assessment: Treatment: Plan:    Vital Signs