C09991402 / invoice 10000

S: Check left hind leg lameness - intially lame in December last year but improved on meds from Wyndham vet clinic. Been intermittently sore on this leg but last few days reluctant to bear weight. Utd with vacc - card sighted. Still eddu ok. O: BAR/anxious, panting, t 38.5, hr 136, bcs 7/9, abdo comfortable, toe touching left hind - no obvious draw sign but gd 2 MPL, also has gd 2 MPL right hind. Uncomfortable in stifle, nad foot, ok with hip extension.A: open - bilateral MPL - ? traumatic flare left hind vs concurrent partial ACL injury? otherP: recc xrays of stifles/hips, start cartrophen inj course and rest and anti-inflamms. Consider specialist orthopedic referral once taken xrays.     Vital Signs    Weight: 7.2;       

*** Examination ***Consulting Vet: JF*** History ***Licking PawsS - O reports that for the last few weeks thatpaddy is back licking his paws again constantly& it has been increasing in frequency in thelast week. O reports it is more the R foot thanthe L. O also reports that he does seem to be anitchy dog, constantly scratching at his ears &rubbing his face. O has questions about whetherthis could be food or shampoo related. Let Oknow yes & can perform food trial onhypoallergenic food with nothing else + get thegroomer to use oatmeal based shampoos with noscentsDiet: fish based dry + cooked meatO - BAR, lovely dog but nervous, HR - >200,no murmur, RR - sniffing, clear all lung fields,MM - pink, CRT - 1.5s, W - 6kg (gained 100g),BCS- 5/9EENT, LN, MSK, Abdomen: NADOral: mild tartar on upper canrassialsIntegument: lickstaining on both FLs, R worsethan L, R has also got severe erythema on palmarsurface with alopecia, LFL mild erythema,cytology cocci +A - Pododermatitis ddx allergies (food,environmental), atopy, otherP - Dispsensed rilexine 150mg BID for 2 weeks +discussed options with pruritic medications iebarazone, cytopoint & apoquel for long term itchmanagement. O elected for barazone today ascytopoint & apoquel too expensive. Discusseddiet trials as well in detail with O & providedinformation on apoquel & cytopointRILEXINE 300MG TABLETS (X14)Give 1/2 (half) a tablet TWICE a daywith some food until all tablets arefinishednew - BARAZONE 100ML (X1)new - Apply 1 pump onto both feet once anew - week on slightly damp skinPd By Card $257.57 VISA AT*** Item Sale Details ***CONS1   Qty: 1.00CYT1   Qty: 1.00RILEX300   Qty: 14.00BARA100   Qty: 1.00DISCPEN   Qty: 26.01    Vital Signs    

*** Examination ***Consulting Vet: zzz*** History ***History Report Printed - 28/07/2023 at 13:15Dates Selected - 28/07/2023 to 28/07/2023- Client Requested Copy.    Insurance*** Item Sale Details ***CONS1   Qty: 1.00CYT1   Qty: 1.00RILEX300   Qty: 14.00BARA100   Qty: 1.00DISCPEN   Qty: 26.01    Vital Signs    Weight: 6 (Converted weight);