C09976683 / invoice 10000

CLIENT COMMUNICATION:
reason: Follow up call O said he is fine (was quite short) said little itchy last night but apparently fine today.          
follow up? N 
initals: DM

Subjective/ Reason: itchy bum

Objective:
Couple weeks ago taken to groomer
Incessantly scratching bum since then. All through the night. Does take occasional breaks
Normal stool
No vomiting
Eating and drinking well 
Still has thickening on dorsal neck where bite wound was, hasn't changed in size

Didn't check gums/teeth as quite head shy now and don't want to make his experience today worse (was really scared previously with bite)
4x4.5cm area of thickened skin on dorsal neck, doesn't feel like fluid. Non painful
Perianal region nice and clear, no redness or swelling
Anal glands both mildly full and expressed liquid impaction

Assessment:
Possibly irritation from anal glands? Groomer could have expressed them

Plan/ Treatment:
Dex 0.1mg/kg sc
Monitor thickening on neck for now, o declined sampling (although really just feels like skin)
Due lepto in 3 months so can recheck then
Follow up tomorrow just to check in and see how he's going

calling in response to email about tick on elvis and to check in
he is well in himself, no concerns
can see up to date quantum 
mentioned tick paralysis signs, unable to swallow or eat, regurg or vomiting, change in bark, lethargy or difficulty walking
but should not see any signs as he is up to date, always good to check regardless
o was concerned as saw tick attached - explained no repellent effect, only seresto collar will repel and stop attaching
but other medications kill the tick and stop them from injecting the toxin which causes signs
advised to call if any questiosn in the future
AZ