C09979547 / invoice 10000

Species:CANINE
Breed:Great Dane Cross
Age (years):4
Diagnosis or signs:Skin consultation
Consult notes
03/03/2026 
NURSE TE 

REASON
- Skin check 

HISTORY
Alopecia and erythema noted on chest over 1 week ago
Atlas not bothered by skin or particularly itchy 
Started giving left over pred 60mg SID for 1 week - noted a slight improvement 
Muscle atrophy of skull noted by Ox

APPETITE: Slightly reduced? would normally finished a full bowl, will now leave food 
THIRST: Drinks a lot but unchanged 
ACTIVITY: Energy levels normal 
DIET: Kibble (chicken and sweet potato), occasional beef treats, apple, blueberries
TOILETING: Episode of multiple vomits 1 week ago, not persisted, no diarrohea 
CURRENT MEDICATIONS:
- Pred 20mg x 3 SID 
- Trazodone 600mg prior to visit 
- Bravecto 3 months ago 

CLINICAL EXAMINATION
Mentation: BAR 
MM: Pink, moist 
CRT: 2sec
Oral Exam and Dental Score: Gr 0-1DD
Eyes: L eye iris cyst - has increased in size
BCS: 5/9
Lumps: None noted or examined
Heart Rate: 100
Respiratory Rate: 28
Temperature: 39.1
Urogenital: NOAD
Skin:
- Multiple ulcerative lesions, crusting alopecia over pectoral region 

CYTOLOGY 
Paraffin oil - no fungal elements or mites noted
Sticky tape prep - clumps of neutrophils, 
Impression smear - Neutrophils, paired cocci 

ASSESSMENT:

DISCUSSION:

PLAN
Cephalexin 1000mg 1.5 tabs BID q14ds
Rv in 14 days - Ox wanting to ring a book 

Animal clinical history (3 most recent)

2025-10-15T00:00:00Z 15:23:41
**
NURSE: EH 

REASON: Recheck + discuss histopath

HISTORY
- x1 off vomit (mostly bile/phlegm) day after GA
- Otherwise been normal 
- No GI upset on metacam 
- Ox has used ear cleaner once, seems to be a reduction in wax but still present 

CURRENT MEDICATIONS: Trazodone on board

CLINICAL EXAMINATION
Mentation: BAR 
MM: Pink, moist
CRT: 1-2
Other findings: Small amount of separation at site, but otherwise healing well

ASSESSMENT:
Should not recur at this site

DISCUSSION:
- Most likely histiocytoma > low chance of recurrence 

PLAN
- No need for revisit 
- Continue ear cleanser 

Previous claim history (13)

DateClaim #Diagnosis
2025-10-08C9322419MASS LESION - SKIN (CUTANEOUS)
2025-09-24C9266833MASS LESION - EYELID
2024-10-14C7815907HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2024-06-11C7334304DESEXING-COMPLICATIONS
2024-06-11C7334304DESEXING-COMPLICATIONS
2024-06-11C7338813DESEXING-COMPLICATIONS
2024-06-03C7304030DESEXING-COMPLICATIONS
2024-06-01C7304060DESEXING-COMPLICATIONS
2024-05-31C7298143DESEXING-COMPLICATIONS
2024-03-05C6959323GASTROENTERITIS
2023-04-14C5799440GASTROINTESTINAL PROBLEMS
2023-04-13C5787306GASTROINTESTINAL PROBLEMS
2023-01-21C5505283PRURITUS - PRESENTING COMPLAINT

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_diagnostic_test_-_cytology168.002026-03-03
20000tstarc_diagnostic_test_-_cytology33.002026-03-03
30000tstarc_diagnostic_test_-_skin_scraping33.002026-03-03
40000tstarc_antibiotics_-_cephalexin155.282026-03-03

UPM+

  • DG02319HYPERSENSITIVITY (ALLERGIC) SKIN DISORDERDSTP_skin_-_allergic_disorder

Variant (sleepy_king)

DERMATITIS
DSTP_skin_-_dermatitis
Conf: 0.430
Threshold: 0.25
Above:
Correct?
Acceptable?
Reason (acceptable)
Diagnosis description