C09998808 / invoice 10000

Reason: Reinflammation of issue on rear legAppointment Notes: Paws App Details:Booking Type: Revisit/RecheckBooking Notes: Reinflammation of issue on rear legOwner Name: Chris CliftonOwner Email: Chris-clifton@bigpond.comOwner Mobile Number: 0408440437Pet Name: FrejaPet Species: DogPet Insurance Provider & Policy No (if applicable & not provided): Not sure - wife does itWeb BookingClient name: CliftonContact number: 0408440437Email address: Chris-clifton@bigpond.comPatient name: FrejaHistory:SummaryRecurrent pressure sore left tarsusCurrent historyFreja presented for recurrence of pressure sore on left tarsus. Started licking at the area again in the last two days. Swelling returned after steroids ceased. Cone on at home.- EDDU: Mildly increased appetite and thirst on steroids, not excessive- Current medication: Prednisolone (recently completed course), Resi-chlor lotion (chlorhexidine) topically- Known medical conditions: Recurrent hot spots/dermatitis, approximately every 6 monthsObjective: Sub: BAR, HR = , no murmur/arrhythmiaRR  bpm, no adventitious lung soundsMMs pink/moist, crt 1sTemp:Eyes: nad shiny clearEars: clean Teeth: clean Coat:shiny, wnl Skin: nad Abdo: comfortable LNs: nad BCS: 6/9MSK: ambulating well Neuro: ne UroG: nad L lateral hock ASSESSMENT:Recurrent pressure sore left tarsus. Common skin issues in Labradors. Likely steroids wore off, itching returned, and licking caused irritation. No antibiotics required at this stageTreatment: - Pred 30mg SID 4 days, then taper - Elocon cream onto lesion - BID 7 days, then taper to once daily - Continue cone when unsupervised- No antibiotics at this stage- Biopsy to be considered if no response or immediate recurrenceClient Communication: If no response or immediate recurrence after this course, biopsy or surgical excision would be considered. Tricky area due to limited excess skin on lower limbs.PLAN:Review if no response or condition recurs. Consider biopsy or surgical excision at that point. Goal to wean off oral steroids and maintain control with topical cream.    Vital Signs    Weight: 33.7;