C10000922 / invoice 10000

o concerned groomer has cut archies eyelid 
due for vacc too

red eye noticed dring week- was coming good
groomed yesterday 
owner noticed bit red raw medial canthus/tear tracks
- eye weeping today - concerned may haev shaved a bit too close
due for vacc

- on Lyka over a year now - loves it
- on amoxyclav and carflexin recently for an infection on the tail - finished about 2 weeks ago 0- can still see the lesion but seems better. 
- hair matted over the lesion so may have been licking at it but owner does not see him doing it
- has had prior cytopoint for skin but did not help, owner feels it improved somewhat since starting Lyka

cv: no murmur/arrhythmia
resp: normal BV sounds, normal rhythm/effort
git: mild calculus, no other oral lesions, abd palp NAD, eating treats well
ears NAD
eyes: pupils equal, normal PLRS
IOP L eye 25 mmHG R eye 27 mm Hg (bit tense and suspect is slightly high due to restraint) 
L eye NSF
R eye mild epiphora mucopurulent discharge
Moderate superficial hyperaemia
eyelids: 
inflammation and moist exudate skin medial canthus
peri ocular dermatitis - papules erythema and small scab present
cytology: small clump granulocytes, low numbers intracellular cocci 
1 yeast seen
No dye uptake

skin: small thickened area of skin lateral tail near base. small amt sebaceous material expressed from a couple of spots. Feels like an empty sebaceous cyst
neuro: responsive, normal mentatio n
ms: ambulatory, no lameness
ln: no lymph node enalrgement

A: periocular dermatitis with secondary bacterial infectio nR eye. 
possibly also yeast infection but only 1 found so may just be incidental finding
underlying cause unknown ddx allergic dermatitis most likely 
- possible sebaceous cyst on tail but not currently inflamed or causing problems

T: tail and eye clipped, cleaned saline. eye flushed saline

P: chloroptsone BID, 
doxycycline 50mg PO q 12 hrs
Owner to clean skin dilute betadine liquid twice daily. 
re-x 7 days. if improving can increase course of doxycycline to 2-3 weeks if necc. 
may also need to add in prednisolone orally for underlying allergy, or topical corticosteroid eg maxidex, but try to get infection a bit under control first to reduce risk of resistance
- can vacc once infection resolved

mornington@penvetcare.com.au
on waitlist for appointment on monday

STO - sons best friend has recently graduated and works with Peninsula Vet Care.
O advised she has been so happy with her treatment at KVP over the years, only moving to support her sons friend. 
Emailed Hx to mornington@penvetcare.com.au

Vaccination

apoqeul for feet?

BAR
mm pink crt<2sec
ears eyes nsf but does need groom and comb out hair around ears
no murmur detected
nad on abdo palpation
stifles stable
bcs 6/9
licks feet frequently, advised try apoquel sid x 3-4 days and see if lickign reduces, was previously jsut usign it for body itch. skin of plantar/palmar surface is not overly erythematous, fianlty pink still smooth

c5 with oral bb