C09996198 / invoice 10000

04/03/2026 Primary Presenting Complaint - Sore dew claw right FL 
Other Complaint - 
         Loyalty Reward Program - Y/N
History - 
- Zoomed around as normal last Friday.
- Noticed dew claw was red and swollen after then.
- Was licking at it.
- Whole paw swelled up on Sunday, has improved a lot since then. 
- Gave leftover pred at home. Seemed to help from what O could tell. 
- Still behaving like her usual self.
- EDUF all normal. 
         Last Normal - Friday
         Medicine Hx  - Pred 5mg
         Diet              - 
         Vacc Current - UTD
         Worming Hx  - UTD
         Heartworm    -
         Microchip       -  Y / N    -  scanned - ok?

Examination - Very limited exam as highly anxious and tried to snap 
         Attitude - BAR, nervous
         Body Score -   5 /10
         Temperature - Not taken
         Heart -   HR. Murmur - Not auscultated 
         RR - Normal rate and effort 
         Dental - Score(0-4)=    .Comment Not examined 
         CRT - Not examined 
         Eyes - NVL
         Ears - No obvious discharge
         Abd Palpation - Not palpated 
         Gastrointestinal -  Not assessed 
         Urogenital -  NSF
         Skin - Moderate to marked erythema ventral abdomen and in between paw pads right FL, no obvious swelling
         Musculoskeletal - Ambulating well, no obvious abnormalities 
         Neurological -  No Sig Findings
         Lymphatic - Not assessed 
         Other key findings = 

Assessment - Acute episode of right forelimb swelling after running around the house. This is the second time the right FL paw has become swollen this year. On exam today the paw is markedly erythemic, there is no evidence of swelling, however it is difficult to fully assess the paw given Berrys temperament. Suspect Berry has allergies as her skin has generalised erythema all over. 
Problem List - 
1. Allergies 
(ddx: atopy vs contact dermatitis vs food allergy)
2. Swelling of right FL paw 
(ddx: self-trauma related to allergies vs foreign body vs trauma vs other)
Discussed      - Swelling in the paw could be related to self-trauma from Berrys allergies but can't rule out other causes - may require sedation for full assessment of paw. O said prednisolone worked well in the past and keen to try again. Advised pred side effects (PU/PD, polyphagia, panting etc) and if paw swelling returns after pred course further assessment is indicated. Brief chat about allergies - diet, bathing, cytopoint, apoquel etc going forward for ongoing management. 
Treatment Plan - 
- Prednisolone course 
Prescriptions(on-going) -
Next Visit            - Revisit if no improvement