C09998054 / invoice 10000

WEIGHT: 22.6
HISTORY: Has a red rash on its belly

06 Mar 04:56pm IW
HISTORY - 
O says rash on belly and licking feet comes and goes, particularly itchy and red at the moment.
Has been on a diet for wt loss.

EXAMINATION - 
Has lost 800g, can do with another 1kg less to be ideal.
Overall clinical OK.
A bit of yellow calculus on teeth (did not mention to O).
Pretty much 2/3 of ventral thorax is erythematous, however erythema disappears up the sides of the thorax--> literally only the ventral/dependent surface is affected.
Very very occasional superficial pimple present mainly in groin, just a smattering of red spots on skin in groin.
Some saliva staining of feet, O says licking front feet more.

LABORATORY - 
Sticky tape prep from ventral chest and feet--> chest no yeast or bacteria; feet--> no yeasts or bacteria but there are lots and lots of pollen cells present

DIFFERENTIAL DIAGNOSIS - 
Contact allergy on chest and feet plus most likely an atopic component as well 

TREATMENT - 
Cytopoint 30mg S/C (840615 2/27)
HCA spray 2 pumps to palm sized area SID
Wear a t-shirt outside to protect skin on chest from contacting irritant.

PLAN - 
R/V if not better in a few days.
If above Tx effective use HCA for break outs, see how long this Cytopoint injection lasts for--> advised supposed to rpt monthly but some may have a longer response.

WEIGHT: 23.4
HISTORY: Is UTD with preventitives- O found tick on head (not sure if alive,but has been removed) chewing at paws for a few days and tummy very red

07 Nov 02:35pm IW
HISTORY - 
O stopped NGS over winter, restarted 3 weeks ago.
Removed a barely alive tick from top of head this morning.
Has been licking/chewing feet past few days, now also red chest.

EXAMINATION - 
Overall clinical OK.
Whole of ventral thorax erythematous, only a tiny patch on R side abdo beside prepuce affected, rest of abdo OK.
Inspect feet--> R fore palmar aspect MC region alopecic and erythematous, some saliva staining of ventral aspects of all feet.  

LABORATORY - 
Sticky tape prep from chest and feet--> no yeasts or bacteria found, lots of pollen cells present though

DIFFERENTIAL DIAGNOSIS - 
Suspect acute contact allergy/irritation

TREATMENT - 
Dexapent 0.7ml S/C
Pred 10mg SID 2d--> 5mg SID 3d--> 5mg EOD for 3 doses--> 5mg twice a week for 1 week.

PLAN - 
R/V if no improvement in 2-3d.

HISTORY: 23 Jun 03:44pm AC

HISTORY -
- EDDU normally, no concerns
- Used to sleep in crate but started barking overnight -- then allowed to sleep in lounge or hallway. When husband went away he would bark overnight -- now sleeps in bed. Owners want to move him out of the bedroom but he barks and wants to be let outside to run around and chase animals in the middle of the night. Won't stop barking until they let him out. Doesn't seem anxious, just wants to go out and play.
- Vomiting about a week ago, has since cleared up
- Prevention: Bravecto 3-monthly maybe but Sarah is not sure; not sure about worming - husband does it

EXAMINATION -
BAR
BCS 5.5/9
Ears/eyes/nose WNL
MM pink, moist
CRT 1s
Dental - minimal to no calculus, no gingivitis 
LNs WNL
HR 72, no murmur
RR panting
Abdo palp NAD
MSK NAD
Integument NAD

ASSESSMENT -
1. Fit for vaccination today

TREATMENT -
1. Kennel cough vaccination: Protech Pi2 SC back of neck L side [5264017; Exp 06.01.2027] + BSO oral [5245044A; Exp 16.07.2026]
2. Nexgard Spectra 15-30 kg dose PO
3. W&P Tapeworm 10 kg dose tablet x 2.5

PLAN -
1. Due for KC booster in 12 months 23/06/2026
2. Recommend late evening exercise and mental stimulation eg training to try to get him to sleep through the night. If possible, ignore the barking as long as possible so as not to reward the behaviour and be consistent in routine. Try to identify triggers -- is he seeing animals outside? Is the cat setting him off? (O suspects either of these are possible triggers for his night time excitement) and prevent them by separating the animals, closing blinds etc.
WEIGHT: 22.5