C09980858 / invoice 10000

Reason: Itchy Skin / Sore pawAppointment Notes: Booked Online: 01/03/2026 15:34:04 PMBooking Type: Skin, Ears, Eyes or LumpsBooking Notes: Itchy Skin Sore paw History: Started scratching again in the last 2 weeks, O want to give another injectionScratching ears as well, O has drops at home and started them this morningLH paws very red.Skin routine: oat meal shampoo and conditioner Tried hypoallergenic diet, no differentHills sensitive skin-> better on this foodE/d?U/D normallyPrevention:Simparica trio UTDExamination: Behaviour: friendlyMouth: clean teeth no erythemaEars: L sever erythema some cream discharge, R moderate erythema Eyes: no swelling/erythema/dischargeCVS: no obvious heart murmur or arrhythmia. Pulse normal and synchronised.Respiratory: normal breathing pattern, on auscultation clear soft lung sound.GIT: no pain found when abdomen palpated. MSK: ambulatory, no obvious lameness.Neu: mentally appropriate.Skin: moderate erythema ventral cranium, axillary, mild erythema inguinal area and flanks, mild hypotrichosis on flanks and ventral chest, clean smooth coat.LN: no enlargement foundLaboratory: Ear cytologyL- malassezia ++, cocci ++R- occasional malassezia and cocciAssessment: OE in LMild dermatitis- allergy (atopy/other) +/- secondary infection- discussed skin cytology or can see if better with topical treatmentPlan:1. Dermotic (O has at home) 1 ml in L SID for 7 day (if runs out, let us know and will dispense more)2. Prednisolone 20mg/tab: 1 tab SID for 5 days, then 1/2 tab SId for 5 days then 1/2 tab EOD for 5 days3. Mediderm Shampoo and conditioner twice a week for 1-2 week then reduce to once a week/fortnight4. Recheck ear and skin in 1 week in 1 week, if OE resolve consider cortavance and austrazole for maintenance5. Cytopoint can do cytopoint on recheck if skin is less inflamedClient Communication: Discussed allergy is a life log condition that needs to be manage (anti itchy, ski barrier, Secondary infection) vs treat (food trail/referral for IMT)Discussed different option for ani itch    Vital Signs    Weight: 28.8;       HeartRate: 180;       DentalGrade: 0/4;       RespirationRate: panting;       CRT: < 2 sec;       MMColour: pink;