C09988432 / invoice 10000

Reason: Sore's On Tummy Appointment Notes: Overdue remindersHISTORY:Presenting complaint: skin irritation with itching and soresOwner reports Frankie has been biting at herself, sometimes suddenly while walkingSores noted under chest areaAnal gland scooting behaviourWeight management concerns - currently 11.5kg, target weight 7kgOwner reports recent major surgery limiting ability to exercise FrankieWeight gain occurred during owner's recovery period when diet monitoring lapsedCurrent meds: noneVaccination: Not mentionedParasite Prevention: Not mentionedPre-existing conditions: obesityAccess to toxins eg. Rodenticide: noneExamination:BAREyes - NAD, pupils same size & reactiveEars - NAD, no visible discharge or inflammation, no smellOral cavity - NAD Mm's pink, crt <2s Resp - NAD, normal heart and lung sounds, no crackles or wheezes on auscultationFemoral pulses strong and synchronous Skin - superficial dermatitis with sores noted under chestLNs - WNLs, symmetricalAbdo palp - NAD, comfortableMSK - NAD, normal gait, weight bearing all 4 limbs Neuro - NAD, normal mentationAssessment:Overweight dachshund with bacterial dermatitis secondary to humid weather conditions. Anal glands palpated with minimal contents.PROBLEM LIST:Obesity (11.5kg, target 7kg)Bacterial dermatitis with superficial skin soresPruritus and self-trauma behaviourAnal gland irritationDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Bacterial dermatitis secondary to humid conditionsObesity with risk of spinal complicationsPossible allergic vs behavioural component to biting behaviourDIAGNOSTICS:NoneASSESSMENT:Overweight dachshund presenting with bacterial dermatitis likely secondary to current humid weather conditions. Significant obesity requiring immediate dietary restriction to prevent spinal complications. Anal gland irritation contributing to scooting behaviour.TREATMENT:Short course steroids for pruritus and inflammationAntibiotics for bacterial dermatitis (store in freezer to reduce vomiting risk)Medicated shampoo (Mediderm) twice weekly for 2 weeks, lather for 5 minutes before rinsingStrict dietary restriction: half current kibble morning portion, 1 teaspoon My Dog evening portion onlyDiscontinue Dentistix temporarilyPLAN:Strict weight management for 3-4 weeks to achieve rapid weight lossMonitor response to medications over next weekReassess if skin condition unchanged or worsening after 1 weekOnce target weight achieved, gradually increase food portions to maintenance levelDistinguish between allergic vs behavioural causes of biting behaviour based on steroid responseCLIENT COMMUNICATION:Discussed serious nature of obesity in dachshunds and spinal surgery risksEmphasised importance of strict dietary compliance from all family membersAdvised that steroids should help differentiate between allergic and behavioural causes of bitingInstructions provided for medicated bathing routineAdvised to return if condition worsens or fails to improve within one week    Vital Signs    Weight: 11.55;