C09987525 / invoice 10000
Species:CANINE
Breed:Miniature Fox Terrier Cross
Age (years):1
Diagnosis or signs:Chronic Skin issue- dorsal back
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div> <div> <p>HISTORY<br>Presenting for: Harli, a female dog desexed at 6 months of age, presented for a chronic and ongoing skin issue on the dorsal back that has been present for 6 months and progressively worsening.</p> </div> </div> <div> <div> <p>Historical Conditions:<br>- Desexed in August 2025 during cooler months<br>- Previously diagnosed with folliculitis<br>- Previous in-house cytology performed but no culture<br>- Previous vets have suggested skin biopsy as next step</p> </div> </div> <div> <div> <p>Diet:<br>- Currently on Proplan puppy dry food<br>- Previously on SPD role but discontinued, now cook for her and continue dry food<br>- Receives cooked egg on Sundays<br>- Fish oil and hemp oil supplementation</p> </div> </div> <div> <div> <p>Drinking/Urination:<br>- Drinks normally<br>- Initially on filtered water but didn't drink as much, switched to normal water</p> </div> </div> <div> <div> <p>V/D/C/S:<br>- Normal bowel motions 1-2 times daily</p> </div> </div> <div> <div> <p>Skin:<br>- Skin lesion initially much smaller, clipped during desexing and has spread from there<br>- Area is spreading and getting bigger<br>- Chews the area overnight as she can turn around and reach it<br>- Client rates pruritus as 10/10<br>- Has started chewing at paws<br>- Flaps ears occasionally<br>- Rolls around when finds ant nest</p> </div> </div> <div> <div> <p>Current Meds:<br>- NexGard Spectra for parasite prevention<br>- PetParks probiotic<br>- PetParks skin support<br>- Fish oil and hemp oil</p> </div> </div> <div> <div> <p>Lifestyle Risk Factors:<br>- Generally hot animal, seeks cool areas and loves water<br>- Goes under couch to seek comfort in small area<br>- Suffers anxiety when pack is broken<br>- Gets overwhelmed and anxious away from home (beach, walks) but settles when left alone at home</p> </div> </div> <div> <div> <p>Other:<br>- Very hypervigilant and active pup<br>- Doesn't like to be picked up initially but melts and snuggles when picked up</p> </div> </div> <div> <div> <p>EXAM<br>Mentation: Very hypervigilant and active, playing constantly<br>T: Not taken due to reactive nature<br>HR: Normal rate and rhythm<br>Behavioural: Very hypervigilant and active, playing constantly, doesn't like to be picked up initially but melts and snuggles when picked up, quite reactive<br>Eyes: Clear<br>Nose: Clear nares<br>Oral: Teeth nicely aligned, no apparent tartar or gingivitis<br>Cardiovascular: Normal HR and rhythm, no audible murmur or arrhythmia, bilateral normal chest sounds<br>Respiratory: Normal RR and rhythm, bilateral normal chest sounds<br>Abdominal: Resents abdominal palpation, suspected referred pain or discomfort from dorsal skin lesion<br>Integumentary: Majority of skin appears normal and healthy. Concentrated but extensive area of acute moist thickened dermatitis on dorsal back along lumbar spine, extending from last thoracic vertebrae to pelvis. Zone of oedema present underneath skin surface with thickened skin and superficial acute moist dermatitis on surface</p> </div> </div> <div> <div> <p>ASSESSMENT<br>Acute moist dermatitis with chronic dermatitis - Extensive lesion on dorsal back with underlying skin thickening and oedema, chronic 6-month duration with recent acute exacerbation, highly pruritic</p> </div> </div> <div> <div> <p>DIAGNOSTICS<br>Skin cytology: epithelial cells. Some neutrophils. Cocci. No yeast observed</p> </div> </div> <div> <div> <p>PLAN<br>New Meds/Tx:<br>- Neocort topically on wound morning and night for 5-7 days, preventing licking<br>- Antinol easy feed capsules for 6-8 weeks (to eliminate beef component)<br>- Chinese herbs based on tongue and pulse diagnosis (wiry to slippery pulse, pink tongue with curling and flat edges, active acupuncture points BL18, Bei We, and BL40)<br>Once finished 5-7days of neocort:<br>- Chamomile or calendula topical application to wound<br>- Coconut oil application at night only (not during day due to burning risk)<br>-cool region when very irritated</p> </div> </div> <div> <div> <p>Change from Nexgard spectra to Simparico trio to eliminate beef component of preventative</p> </div> </div> <div> <div> <p>Diet Recs:<br>- Transition off dry food and current unbalanced homemade diet over one week<br>- Start Lyka diet eliminating chicken and beef, using lamb, turkey, and kangaroo varieties<br>- Transition from PetParks probiotic to Entrapro probiotic for dogs</p> </div> </div> <div> <div> <p>Additional Discussion:<br>- Continue chamomile-based shampoo and lotion sourced online through Dr Chris Brown<br>- Stop access under couch in case of contact irritant from couch ventrum<br>- Owners to source cotton shirt as barrier in case of contact irritant or scratching<br>- If condition continues, may culture wound<br>- Chinese medicine approach incorporated with tongue and pulse diagnosis performed</p> </div> </div> <div> <p>Revisit 2-4weeks into changes or before if any concerns<br><br>Si Miao San is chosen chinese herb based on pulse findings, excitable state and findings. Best fits the presentation. </p> </div></html>
Previous claim history (11)
| Date | Claim # | Diagnosis |
|---|---|---|
| 2025-11-27 | C9546526 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-10-23 | C9392802 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-10-23 | C9392802 | LAMENESS LH |
| 2025-10-08 | C9322867 | HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER |
| 2025-10-08 | C9322867 | HEARTWORM CONTROL |
| 2025-08-07 | C9064130 | DESEXING |
| 2025-05-09 | C8687209 | Grooming |
| 2025-05-09 | C8687209 | VACCINATIONS OR HEALTH CHECKS |
| 2025-05-09 | C8687209 | FLEA/TICK/WORM CONTROL |
| 2025-05-09 | C8687209 | HEARTWORM CONTROL |
| 2025-04-17 | C8602222 | INGEST FOREIGN OBJECT |
Line items(lines with upstream diagnosis are skipped by the model)
| Line | tstarc | Amount | Date | Upstream diagnosis |
|---|---|---|---|---|
| 10000 | tstarc_consultation | 170.00 | 2026-03-02 | — |
| 20000 | tstarc_consultation | 55.00 | 2026-03-02 | — |
| 30000 | tstarc_diagnostic_test_-_cytology | 50.00 | 2026-03-02 | — |
| 40000 | tstarc_skin_medication_-_topical_antibiotics_and_anti-inflammatory | 42.27 | 2026-03-02 | — |
| 50000 | tstarc_chinese_herbs | 70.00 | 2026-03-02 | upstreamDSTP_alternative_therapy_-_unspecified |
| 60000 | tstarc_postage/freight/travel | 25.00 | 2026-03-03 | upstreamDSTP_general_exclusion |
UPM+
- DG02319HYPERSENSITIVITY (ALLERGIC) SKIN DISORDERDSTP_skin_-_allergic_disorder
Variant (sleepy_king)
DERMATITIS
DSTP_skin_-_dermatitis
Conf: 0.670
Threshold: 0.25
Above: ✓
Correct?
Acceptable?
Reason (acceptable)
Diagnosis description