C09975980 / invoice 10000

Appointment Notes: Overdue remindersVerified: NoHistory:Presenting for: Bella, a Cavalier King Charles Spaniel, presented for Cytopoint injection for allergic skin disease and owner concerns about eye discharge.Historical Conditions: History: of ear issues. No cardiac disease noted (unusual for breed - typically have heart murmurs).Skin: Chronic allergic skin disease with scratching and licking behaviour affecting paws and back. Cytopoint injections scheduled monthly but owner tries to extend intervals. Cytopoint provides complete resolution of scratching and licking when administered.Current Meds: Cytopoint injections for allergic dermatitis - due for administration.Examine:Wt: 13.4 kg (previous weight 12.8 kg)Eyes: Mild tear staining and discharge consistent with brachycephalic conformation. Conjunctiva normal with no redness or irritation. Tear ducts compressed due to flat facial structure causing normal build-up and discharge.Ears: Mild pruritus secondary to allergic disease. No infection present.Cardiovascular: No heart murmur detected.Integumentary: Irritation and scratching lesions on paws, particularly visible on one paw. Irritation also noted on back. Changes consistent with allergic dermatitis without secondary bacterial infection.Rectal: Anal glands palpated and found to be full. Anal glands expressed.Diagnostics: Ear swabs - no infection detected.Assessment:Allergic dermatitis - chronic condition with good response to Cytopoint therapy. Current flare with paw and back irritation.Impacted anal glands - both dogs in household affected with scooting behaviour.Plan:New Meds/Tx:- Cytopoint injection administered subcutaneously for allergic dermatitisAdditional Discussion:- Owner advised eye discharge is normal for brachycephalic breeds due to compressed tear ducts- Anal glands expressed for both dogs due to scooting behaviour- Recheck recommended if skin irritation persists despite Cytopoint treatment    Vital Signs    Weight: 13.4;