C09988851 / invoice 10000

Reason: NPC - Facial Injury (WEB)Appointment Notes: Lexi (Dog) - Consultation - sickness/injury (new issue) [Veterinarian : Dr Amy Stewart(No Preference)] - Facial injuryWeb BookingClient name: Garrett SmithContact number: 0433338988Email address: gazcsmith@gmail.comPatient name: LexiHistory:Presenting for: Lexi presented for examination of a skin lesion under the left ear that developed yesterday, with associated scratching and bleeding.Historical Conditions:- Previously diagnosed with atopic dermatitis, managed with Cytopoint injections until October 2025- Spayed - skin irritations improved significantly post-surgery- Contact allergy episode last week, suspected from creeping dew exposureDiet:- LaMica dry food, 800g daily (manufacturer recommends 1kg for her size)- Occasional dry piggy treats during walks- Sometimes accesses cat foodSkin:- History of chronic atopic dermatitis with intermittent hot spots- Regular bathing for management- Occasional small heat spots around ears and mouth area- Recent contact allergy reaction in backyardCurrent Meds:- Discontinued Cytopoint in October 2025- Topical Neocort applied yesterday to affected areaLifestyle Risk Factors:- Attends doggy daycare- Regular beach visits and saltwater exposure- Dog park accessOther:- Most of backyard access restricted due to creeping dew concerns- Weight management ongoing - was 27kg, increased to 29kg over Christmas period, currently trying to reduce back to 27kg- Possibly overdue for annual vaccinationsExamination:Wt: Current weight discussed in context of weight management (target 27kg)BCS: Overweight - attempting weight reductionBehavioural: Accepts treats during examinationEars: Left ear examination revealed skin lesion extending from under the ear. Right ear appears normal on external examination, unable to visualise ear canal completelyIntegumentary: Focal skin lesion under left ear with evidence of self-trauma from scratching. Small scar noted on left foreleg, possibly from scratching or rough play. Lesion has been bleeding intermittentlyAssessment:Focal pyoderma secondary to self-trauma - likely hot spot development under left ear with bacterial secondary infectionPlan:New Meds/Tx:- Apoquel chewable tablets, one tablet once daily to reduce pruritus- Antibiotic tablets, one tablet morning and evening (3 tablets dispensed)- Prednisolone (Macrolone) 1.5 tablets once daily - short-term use for anti-inflammatory effect, can discontinue after 2 days if significant improvement noted- Elizabethan collar dispensed (20cm) to prevent further self-trauma - remove during supervised exercise, replace when at homeDiet Recs:- Reduce LaMica from 800g to 600g daily for weight management- Consider healthier treat alternatives such as carrot or cucumber- Restrict access to cat foodAdditional Discussion:- Annual vaccinations postponed until skin condition resolves due to concurrent antibiotic therapy- Avoid saltwater/beach activities until lesion heals due to potential contamination from recent rainfall- Betadine dilution discussed for topical cleaning if needed- Monitor for improvement over next couple of days - collar can be removed once scratching behaviour stops    Vital Signs    Weight: 30.1;