C09972672 / invoice 10000

Reason: Large Lumps Appearing Over BodyAppointment Notes: Possible allergic reaction to something - mhHistory: Last 30 min acute onset hive type swelling noticed on face. Intiialyl saw one on muzzle but more have come up on face/muzzle si. Not been irrirated, not rubbign and otherwise looked normal in self, BAR. No v+/d+ seen. Had cytopoint inj last week. Was speyed 10d ago, reocvered well in self but skin did flare up from using body suit and had a few area of pyoderma on front legs. Was put on abx last week and O also using topical cream and is clearing up well. Examine: BARAmbulatoryMM pink CRT <2s. NAD chest auscultation and abdominal palaption; regioanl ln's wnl Ears wnl Skin: - 4-5 raised swellign on face/muzzle, look coistent with hives/urticaria.- resolving pyoderma front legs as above. - small red spot skin near dorsal vulva, doesnt look like a hiove,m suggest using topcial cream o has at home on this spot as well. Assessment: No bee sting found on exam but suspect urticaria reaction to insect or arthropod sting/bite. Treatment: Gave 0.17 ml dexapent 5 mg/ml SC and 0.45 niramine SC Home with niramine for the next 2.5 days: 4 mg PO BID from tonight. Plan: RV if not settling    Vital Signs    Weight: 8.6;       MMColour: pink;       HeartRate: 150;       BodyScore: 5/9;       DentalGrade: 0 ;       CRT: <2;