C09976865 / invoice 10000
Species:CANINE
Breed:American Staffordshire Terrier
Age (years):1
Diagnosis or signs:skin consult (24.7 kgs)
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><p>HISTORY:<br>Ramona Wilson presented for worsening pruritus and excessive licking of perianal region. Owner reports Cytopoint not working as effectively as previously. Increased itchiness this month with incessant licking of anal area. Owner has expressed anal glands twice this month.<br>Owner concerns: Breakthrough itching despite Cytopoint treatment, excessive perianal licking, frequent anal gland impaction.<br>Bathing with Alaveen shampoo regularly. Patient described as quite yeasty.<br>Past medical history includes food and atopic dermatitis with known allergy to kangaroo and grass/pollen allergies. Previously well controlled on Cytopoint 30mg every 4 weeks. History of plastic ingestion requiring emesis induction.<br>On any medication: Cytopoint 30mg subcutaneous every 4 weeks, last given 06/01/2026.<br><br>Examination:<br>Behaviour in consult: anxious during examination, particularly for perianal procedures<br>vitals are within normal limits<br>BAR<br>Eyes: grossly normal<br>Ears: grossly normal<br>Mouth: grossly normal<br>Integument: moderate erythema of ventrum and inguinal region, muzzle, some interdigital erythema particularly hindlimbs, perivulvar dermatitis and ceruminous material- slightly recessed vulva<br>CV: grossly normal<br>Resp: grossly normal<br>Abdo palp: grossly normal<br>Nails/feet: no abnormalities noted, owner reports no foot licking<br>Musculoskeletal: grossly normal<br>LNs: grossly normal<br>Urogenital: grossly normal<br><br>Problem list:<br>1. Atopic dermatitis flare<br>Assessment: Breakthrough pruritus despite Cytopoint therapy with secondary bacterial and yeast overgrowth<br>Differential diagnosis: Environmental allergen exposure, skin barrier breakdown, secondary pyoderma and malassezia<br>Investigations: Skin cytology performed - superficial pyoderma identified with moderate bacterial overgrowth, occasional yeast present<br><br>ASSESSMENT:<br>Atopic dermatitis with breakthrough pruritus despite current Cytopoint therapy. Secondary superficial bacterial infection contributing to clinical signs. Localised to perianal and ventral regions.<br><br>TREATMENT:<br>Cytopoint 30mg subcutaneous administered<br>Apoquel 16mg SID 14 days and then stop<br>Malaseb shampoo prescribed for use twice to three times weekly, particularly affected areas, contact time 10-15 minutes<br>Omega 3-6-9 supplement prescribed as pipettes, applied to back of neck once weekly for skin barrier support<br>Medicated conditioner recommended as leave-on spray after bathing<br><br>Task summary:<br>Recheck appointment scheduled in 2 weeks to assess response to treatment<br>Consider alternative therapies (Apoquel or Zenralia) if no improvement<br>Monitor for treatment response and potential need for immunosuppressive therapy adjustment</p></html>
Animal clinical history (3 most recent)
2026-02-03T00:00:00Z 15:33:00
gave a 30mg cytopoint SC
2026-01-06T00:00:00Z 09:46:00
History: No abnormalities at homePx: Vitals within normal limits. BAReyes: WNLsears: WNLsoral: WNLSChest auscultation: Unremarkable chest auscultationAbdominal palpation: Unremarkable abdominal palpationDermatology: moderate erythema of the ventrumUrogenital system: unremarkableGait: normalMusculoskeletal system: unremarkableNeurological examination: unremarkablePLNs: within normal limitsDifferential diagnosis:Atopic flareTreatment plan:Fit for vaccination C5 + cytopoint 30mg
2026-01-05T00:00:00Z 16:43:00
History: Starting to scratch again on LT cytopointPx: Vitals within normal limits. BAReyes: WNLsears: WNLsoral: WNLSChest auscultation: Unremarkable chest auscultationAbdominal palpation: Unremarkable abdominal palpationDermatology: skin unremarkable on exmainationUrogenital system: unremarkableGait: normalMusculoskeletal system: unremarkableNeurological examination: unremarkablePLNs: within normal limitsDifferential diagnosis:Healthy and fit, unremarkable PxTreatment plan:Fit for vaccination C5cytopoint 30mg
Previous claim history (16)
| Date | Claim # | Diagnosis |
|---|---|---|
| 2026-02-03 | C09846154 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2026-01-05 | C09711027 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-12-23 | C09666944 | DIETARY INDISCRETION - FOREIGN BODY INGESTION - PRESENTING COMPLAINT |
| 2025-12-05 | C09584517 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-11-07 | C9461745 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-10-20 | C9374386 | GASTROENTERITIS |
| 2025-10-20 | C9374621 | GASTROENTERITIS |
| 2025-10-20 | C9376244 | BEHAVIOUR DISORDER |
| 2025-09-30 | C9291462 | GASTROENTEROPATHY |
| 2025-09-29 | C9299614 | DIARROHEA |
| 2025-09-18 | C9281642 | BEHAVIOUR DISORDER |
| 2025-08-12 | C9140931 | BEHAVIOUR DISORDER |
| 2025-07-03 | C8936725 | DESEXING |
| 2025-02-11 | C8317957 | TOOTH FRACTURE |
| 2025-01-31 | C8279384 | GASTROENTERITIS |
| 2025-01-31 | C8279384 | PRESCRIPTION DIETS |
Line items(lines with upstream diagnosis are skipped by the model)
| Line | tstarc | Amount | Date | Upstream diagnosis |
|---|---|---|---|---|
| 10000 | tstarc_diagnostic_test_-_cytology | 70.00 | 2026-03-03 | — |
| 20000 | tstarc_skin_medication_-_cytopoint | 233.44 | 2026-03-03 | — |
| 30000 | tstarc_skin_medication_-_apoquel | 118.53 | 2026-03-03 | — |
| 40000 | tstarc_consultation | 96.00 | 2026-03-03 | — |
| 50000 | tstarc_supplement_-_skin_supplements | 39.85 | 2026-03-03 | upstreamDSTP_alternative_therapy_-_unspecified |
UPM+
- DG02319HYPERSENSITIVITY (ALLERGIC) SKIN DISORDERDSTP_skin_-_allergic_disorder
Variant (sleepy_king)
HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.690
Threshold: 0.38
Above: ✓
Correct?