C09997852 / invoice 10000

Appointment Reason: Skin problem, Appointment Notes: Possible skin bacterial infection ? - User: Dr. Hanson Tan Original Appointment Type: WEB - Consultation - 1. HansonDiagnosis: allergic urticaria flare likely with  secondary bacterial component  (pustules) weight loss open --------SUBJECTIVE:--------Owner reports:- seemed to come out in hives last week or so and super irritated all over, itching alot - did go off leash in a bush/park recently so O worried might be that - hasnt really had episode like this before - has small red welt all over body, seemed to start around the R ear  - otherwise has been generally fine, good appetite and thirst, no v+ or d+ Appetite: normal Diet: five hounds dry + some homecooked Drinking: nadUrination: nadDefecation: nadDesexed: Y Worming:HWP:Flea prevention:Other medications:---------------OBJECTIVE:---------------Mentation: BAR, FAS 2 Eyes:  ok Ears: ok Oral Cavity: pink moist mm, crt < 1.5  Thoracic Exam:Lymph nodes:Abdomen:Reproductive:Skin / Coat:- generalised miliary papular urticaria + pustules all over ventrum/caudal thighs, inguinal region + under ears - dry coat generally + scale present - pruritic Flea Comb test: -ve Perineal / Ag's :Rectal Exam ( > 7yo) :Gait / Extremities:------------------ASSESSMENT:-------------------suspect allergic flare - urticaria + secondary bacterial component O has appt next tues with SASH for review post thryoid/pulmonary neoplasia treatment weight loss - open Treatment: cytopoint amoxyclav ---------------------PLAN:--------------------FUC post sash visit; if scan is all clear, consider addition pred if skin still not 100% vs skin biopsy if worse    Vital Signs    Weight: 17.2;