C10002699 / invoice 10000

Reason: HotspotConsultation Time: 09/03/2026 07:14:36History:Hamish presented for assessment of a skin lesion. Hamish has a history of hypothyroidism and is receiving thyroxine medication twice daily. Blood tests for thyroid monitoring were performed approximately one week ago. Hamish also has a history of back pain, secondary to an attack by a bull terrier approximately ten years ago, which resulted in two vertebrae being in close proximity. He receives carprofen and gabapentin for this. The owner reports he is eating well.The owner reports that this has been a difficult week and they may not have noticed the skin lesion as early as they might have otherwise.Subjective:Hamish is bright, alert, and responsive. Objective: Temp: 38.4°C MM: Pink CRT: <2 seconds HR: 128 bpm FP: Strong and synchronousBCS: 7/9 Wt: 5.8 kgPain Score (CSU):  1/4CV: No murmur or arrhythmiaRESP: Normal bronchovesicular sounds, no nasal discharge, normal respiratory effortRR: PantingGIT: Comfortable on abdominal palpation. U/G: No preputial discharge Neuro: Appropriate mentationM/S: AmbulatoryInteg: There is a raised, ulcerated skin lesion with purulent exudate in the centre, measuring approximately 2 cm by 1.5 cm. The lesion is located on the right cranial dorsal aspect of the jaw, in the region where a venipuncture may have been performed. Hamish was observed scratching at the lesion after topical treatment was applied. An E collar has been placed.Ophth: Pupils equal and appropriateLNs: Palpably normalProblem List:- Infected and ulcerated skin lesion on the right jawline.- Pruritus associated with the skin lesion.- Hypothyroidism, currently managed.- Chronic back pain, currently managed.Assessment:The skin lesion is likely a localised infection, potentially complicated by an underlying immunocompromised state secondary to hypothyroidism. The location suggests it may be a complication from a recent venipuncture site where the skin has not healed effectively.The area has been clipped and cleaned with antiseptic.Dispensed neocort cream and short course of oral antibiotics given immunosuppression with hypothyroidism. Recheck with RV in 2-3 days. Treatment:- The affected area was clipped and cleaned with an antiseptic solution and flushed.- Neocort cream applied to the lesion.- Amoxyclav 75mg PO q12h to manage the infection, given the concurrent hypothyroidism.- An Elizabethan collar was fitted to prevent self-trauma from scratching.Plan:As aboveClient Communication:Discussed the nature of the skin lesion with the owner, including the potential link to the recent blood draw and compromised healing secondary to hypothyroidism. Explained the treatment provided and the plan for ongoing care at home. The importance of keeping the Elizabethan collar on was emphasised. The owner was advised on how to remove the collar for feeding if necessary (it has a Velcro fastening) and how to raise the food bowl to facilitate eating with the collar on. Advised a recheck appointment later this week. The owner's questions were answered, and they consented to the treatment plan.    Vital Signs    Weight: 5.8;       

Time:Weight-RR -RE -HR - 126bpm HM 2/6CRT - < 2 secsMM - pinkT° - 38.9Brief History Another dog at home stepped on Hamish's FLs @ 14:30 pm, no fracture. Gabapentin and meloxicam on board for arthritis. Advice Given to Client: Resting at home, continue meds and RV tomorrow with regular GP if needed. O aware and brought home.    Vital Signs    Weight: 6;       Temperature: 38.9;       

Reason: ItchyHamish presented due to unresolved itchiness that made him unable to settle and distressed at home.Earlier in the day, around 10am, Hamish was taken to a park for scent training. There was nothing usual to note however on the drive home Hamish vomited and seemed very irritated. The owners went to their regular veterinarian where he was given an injection of maropitant and niramine. He seemed to settle well throughout the afternoon however had an episode of what the owner described as severe irritation where he was scratching continuously and pacing around. The owner noted he seemed to have improved since then. Hamish has a history of skin irritation and takes apoquel.Hamish has not had any episodes of diarrhoea and was eating and drinking normally throughout the day.On presentation Hamish was very bright and all his vitals were WNL. He did not have any instances of scratching and the owner agreed. The owner elected to take Hamish home as multiple critical patients had arrived and there were extended wait times. There were no episodes of discomfort whilst waiting. They were told to return if symptoms persist, there were any more episodes of vomiting, he refused dinner or became very unsettled. The owner was happy with this plan.    Vital Signs    HeartRate: 192;       RespirationRate: Pant;       PainScore: 0;       CRT: <2;       MMColour: Pink;