C09972142 / invoice 10000

Reason: Itchy / Vaccination / LumpsAppointment Notes: Paws App Details:History:Presenting for: Chips, a 1 year old dog, presented for routine vaccinations (Kennel Cough, Lepto, and core vaccinations) with owner concerns about small lumps on his chin and excessive foot licking.Skin: Multiple small lumps noted on chin area by owner. Excessive foot licking reported - intermittently bright pink paws, sometimes normal. Owner reports dog rubs belly and face on grass frequently.V/D/C/S: Episode of severe vomiting and diarrhoea approximately one week ago (single occasion, suspected plant ingestion). Ongoing temperamental stomach with variable stool consistency - often soft, sometimes liquid, particularly at the end of defecation.Diet: Fed kibble as primary diet with regular leftovers from family dinners.Examine: Mentation: BAR but nervousBehavioural: Nervous on presentation, described as normally excitable, yappy, and jumpyIntegumentary: Multiple small lesions on ventral neck/chin area with erythema and staining. Lesions appear as superficial abrasions with pattern consistent with scratching rather than bite wounds. Interdigital erythema noted on paws.Cardiovascular: Heart and lungs auscultated - no abnormalities detectedLaboratory: Diagnostics: Skin cytology from neck lesions - bacterial infection identifiedAssessment:Superficial pyoderma secondary to pruritus - Bacterial skin infection likely secondary to allergic dermatitis based on clinical presentation and cytology findings. Suspect environmental allergens given age and clinical signs including foot licking and neck scratching.Treatment: Lepto A003A0210.26BB/Pi 252620704.27DHPPi 242990310.26Plan:- Kennel Cough, Lepto, and cire- New Lepto vaccine requires booster in 1 month due to updated vaccine protocol with additional strain coverage for local area protection- Antibiotics prescribed: 1/4 tablet twice daily (morning and night) until finished- Short course steroids prescribed: 1/2 tablet once daily for 3 days, then 1/4 tablet once daily for 3 days, then 1/4 tablet every second day until finished- Cytopoint injection discussed but deferred pending response to current treatment Plan:Client Comms:- Recheck appointment scheduled in 1 week to assess treatment response- Return in 1 month for Lepto booster vaccination- Call if condition worsens or fails to improve    Vital Signs