C09991046 / invoice 10000

Reason: Ongoing Skin IssuesHistory: Ongoing skin issues. Pruritus returned 2d post cessation of recent pred course. Lesions start out as small hives and then go to larger, alopecic round lesions w some mucopurulent discharge.Fish based dry food (ProBalance Sensitive) but does get chicken necks and odd table scraps (chicken, pork, beef).  No change in environment. Gracie spends a lot of time indoors. UTD flea and tick prevention (Nexgard Spectra).Gracie is insured and O. Is going up to QLD next month for a holiday (Gracie is going too). Examination: Multiple round crusting lesions, of varying size, over integument - ext pinnae, ventral abdomen, lateral HLs.Woods lamp negativeBAR. Vitals WNL. No heart murmurs detected. Aural/ocular examinations NAD. Laboratory: Sticky tape impression: Cocci +++++, occasional pollen, no fungal components seenDifferential diagnosis: Bacterial dermatitis: food allergies vs environmental vs atopyTreatment: 50mg cytopoint SQPlan: Dispensed 775mg amoxyclav PO BID for 2 weeks. Feed ONLY fish based diet, no table scraps or chicken necks. Malaseb washes q2d for 2 weeks. If worsening, revisit ASAP. Otherwise, revisit in 2 weeks if no improvement. Strongly recommended referral to Dermatologist in Brisbane as next step, ideally to coincide w O.'s holiday next month.    Vital Signs    Weight: 45.6;