C09994089 / invoice 10000

Species:CANINE
Breed:Cocker Spaniel
Age (years):5
Diagnosis or signs:Discuss allergies
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div>
<div> </div>
</div>
<div>
<div> </div>
</div>
<div>
<p>Since moving to gisborne 1.5 years ago she has had ongoing issues with AGs, lip issues, or ear infections. No history prior<br>Lips are an issue currently<br>AGs ok, were expressed a month ago<br><br>Examination<br>Lip fold dermatitis - clipped and cleaned with chlorhex<br>Mild erythema on belly and feet<br><br>Assessment<br>Suspect environmental allergies<br><br>Plan<br>Start apoquel BID then drop to SID, revisit in 2 weeks to check lip fold (we are trying to use Abx but can add in if needed)<br>Owner will likely switch to cytopoint moving forward as this will probably be more convenient, but discussed that cytopoint may not last as long when there is active infection<br><br></p>
</div></html>

Animal clinical history (3 most recent)

2026-02-06T00:00:00Z 11:35:00
HNo health concerns currentlyHas been licking at bottom a bit - gets her AGs done semi regularly, history suggests about every 5-6 weeks over summer, but more like q3months over winterOccasinally licks her feet, but not oftenEHeart - no murmur or arrythmiaResp - lungs clearEyes, Nose, ears - NADMM pink and moist, CRT<2Teeth Grade 2/4 - moderate calculus, minimal gingivitisAbdo comfortableSkin NADMSK NADAGs - left small, right moderate in size, both take a bit to get moving as thick contents but express easily once movingAhealthy to vaccinate - Vaccination C5 given asDuramune 3 yr DHP C3 given SC, andyearly Canigen KC (BB/PI2) SC injectionPlanNext vacc in 12monthsBook in for SPA dental, est $900 - owner will aim for AprilDiscussed that allergies may be behind AG issues, could consider apoquel trial, or continue expressing them as needed
2025-12-22T00:00:00Z 11:12:00
anal glands expressed, thick concistancy 
2025-11-06T00:00:00Z 10:14:00
 Had lip fold dermatitis in Aug 2025,did improve with chlorhex and antibiotics, but has come back againHas been cleaning the lip fold area with chlorhex once or twice a weekExaminationHeart and lungs NADLip folds - moderate amount of black discharge in the lip fold area, left worse than right. Moderate erythema in this area alsoAGs - both small, normal contentsAssessmentLip fold dermatitis - query underlying allergyPlanBack onto daily chlorhex cleaning, and noroclav BID for 14 days, then recheck to assess area, and discuss whether to consider allergy medication trial (apoquel or cytopoint), or manage area with topical elocon weekly

Previous claim history (8)

DateClaim #Diagnosis
2025-11-06C9452518DERMATITIS - LIP-FOLD
2025-11-06C9452518Preventative/Elective Procedure
2025-04-07C8551563EAR INFECTION
2025-03-31C8523093EAR INFECTION
2025-02-22C8366323EAR INFECTION
2025-02-12C8339740EAR INFECTION
2025-01-25C8293281EAR INFECTION
2021-11-16C4255053Grass Seed Abscess

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_skin_medication_-_apoquel85.202026-03-06
20000tstarc_chlorhexidine28.702026-03-06
30000tstarc_consultation-revisit79.002026-03-06

UPM+

  • DG02319HYPERSENSITIVITY (ALLERGIC) SKIN DISORDERDSTP_skin_-_allergic_disorder

Variant (sleepy_king)

HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.740
Threshold: 0.38
Above:
Correct?