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Appointment Notes: Paws App Details:Booking Type: ConsultationBooking Vet: - Any -Booking Notes: Constant bum lickingPet Insured: YesVerified: NoHISTORYPresenting for: Sizzle, a 2-year-old dog presented for excessive licking of the perianal area for approximately 2 weeks duration.Historical Conditions:- No previous anal gland issues- Recent grooming with clipping of perianal area approximately 1 week ago but licking had started prior to this. Diet:- Home cooked chicken and vegetables- Appetite normalSkin:- Owner's husband reports smell of blood from perianal area but no blood seen. - No blood visible in faeces- Faeces described as solid consistencyNo prior skin issues. EXAMMentation: BARBehavioural: Cooperative during examination, is a 'care' dog. Attempted muzzling but Sizzle became cyanotic and stressy, removed muzzle and O was able to hold head end. Limited exam possible. Integumentary: Brown discolouration of fur  present in perianal region from chronic licking. No perianal dermatitis present at this stage. Skin not affected despite ongoing licking behaviour.Rectal: Bilateral anal gland impaction identified. Anal glands expressed - no blood present in expressed material. Solid faecal consistency noted. Anal glands were impacted but not inflamed or infected.ASSESSMENTImpacted anal glands - bilateral impaction with no evidence of inflammation or infection. Likely cause of perianal irritation and excessive licking behaviour.PLANAdditional Discussion:- In small dogs, anal glands commonly become impacted when they cannot express naturally- If licking continues despite anal gland expression, food allergies should be considered as perianal licking can indicate food sensitivities- Chicken is a common allergen in dogs- Hypoallergenic diet trial may be recommended if licking persists- Return for anal gland expression if licking behaviour recurs- Monitor for development of dermatitis if licking continues    Vital Signs    Weight: 9.5;       

Reason: How Are Ears & Skin?Called and spoke to owner - advised ear skin is looking a lot better now - o grateful.Appointment Notes: Paws App Details:Booking Type: Consultation Ear/Eye/Skin ProblemBooking Vet: - Any -Booking Notes: Reaction to Dermotic 20mg, skin is peeling inside the earsPet Insured: YesThe following questions were asked during a follow up call to this pet's ownerEating and drinking? yesUrinating and defecating? yesDemeanour? goodPain level, discomfort/distress noted? noAny vomiting or diarrhoea? noAny issues giving the medication? noRecheck Booked? (add date of booking) Any other questions/concerns? no    Vital Signs    

Reason: Ears / SkinAppointment Notes: Paws App Details:Booking Type: Consultation Ear/Eye/Skin ProblemBooking Vet: - Any -Booking Notes: Reaction to Dermotic 20mg, skin is peeling inside the earsPet Insured: YesHISTORYPresenting for: Patient presented with skin peeling inside ear pinna, suspected to be a reaction to ear drops.Historical Conditions: Recent ear infection with redness and inflammation.Current Meds: Ear drops (recently discontinued due to reaction). Oral steroids recently prescribed.EXAMEars: Peeling skin bilaterally but likely fresh skin coming up and is sign of healing. Skin underneath appears to be new tissue forming. No active infection present. Veterinarian noted this appears to be normal skin healing rather than an allergic reaction.Integumentary: Dry, peeling skin around ears. New skin visible underneath the peeling areas. Some scabby formation noted. Patient scratching at affected areas.Diagnostics: Otoscopic examination performed - no current infection visible. Cytology negativeASSESSMENTResolving otitis externa - Skin peeling represents normal healing process following previous inflammation rather than allergic reaction to medication. New skin formation visible underneath peeling areas.PLANNew Meds/Tx:- NecortTopical cream containing antibiotics, steroids and numbing agent prescribed for application to external ear areas BID for several days to reduce itching and protect healing skin.Client Comms:- Advised that skin peeling is normal healing process, not an allergic reaction- Instructed to prevent patient from scratching affected areas to avoid damaging new skin- Apply prescribed cream to external ear areas BID    Vital Signs    Weight: 8.3;