C09995059 / invoice 10000

04/03/2026 Revisit reason: skin
History:
- previous history of dermatitis that took a while to resolve but seems to have returned with vengeance 
- dog likes to swim in the ocean and in the pool, does not get rinsed after 
- pruritic now but was not previously 
- had borderline low T4 last checked (December 2025) o was going to consider Free T4 and TSH testing 
Medications: malaseb shampoo
EDUF: WNR
Mentation: BAR, sweet dog
BCS (0-5):      3/5
HR: 108
RR: panting
MM:     pink             
CRT: 1s
Temperature: NT

Any additional findings:
- large circular lesions of hair loss, erythema and crusting at the margin with hair falling out in tufts 
- mainly along spine and in the groin 
- lesions resemble multiple large hot spots 
Assessment:
- dermatitis of unknown origin, given recurrence previously biopsy was discussed but not performed, advised to get done when NOT ON MEDS 
- suspect possible sebaceous adenitis 
- skin tape cytology- occasional cocci, no yeast

Treatment:
- enrofloxacin 150 mg SID and Pred tapering dose - responded previously 
- do not swim until all lesions have resolved !
- wash 2x week with Malaseb and then apply Alpha-Kerri oil - 1 capful in 1 liter of warm water and use as final rinse, leave on skin.   
- start on Megaderm 

Plan: book in with Dr. Meng on 15. April, until then re-check in 14 days , consider biopsy - must be off meds for at least 7 days , may need to extend Pred if skin looking much better and just stop tab's