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Appointment Notes: VETSTORIA - Harry (Dog) - Consult Illness [Veterinarian : Vet Consultation 2(No Preference)] - Sore left paw -  - 0424996511 - -Web BookingClient name: Erina CzinnerContact number: 0424996511Email address: czinnere@gmail.comPatient name: HarryHistory: BIB: ErinaVaccines: UTDParasite Prophylaxis: UTDEDDU: WNLWent to sash last week for irritation on feet, o was told it was larval ticks so o has treated with frontline and allowed harry to lick it off. O spent much of the consult explaining she felt dismissed at sash and was worried because harry was breathing differntly, so she decided to present to sash emergency. Also explained that harry's 'bloods were normal' at sash Examination:BAR, BCS 4/5, NAD chest auscultation and abdominal palpation, HR 100bom, no murmur on auscultation..Eyes ok Ears clearTeeth dental disease grade 1MM pink, CRT 1 sec. Temp 38.0. Lns WNL. Skin - interdigital erythema and salivary staining all 4 feet, cyto: ++ cocci.Assessment:Interditigal dermatitis with secondary infection of cocci due to underlying allergiesTreatment:Feet washed in chlorhexadine bath as requested by o Cytopoint 20mg given SC Left thigh (as requested by o)Batch no: 840616Expiry: 02.2027Plan:Long conversation about causes of behavioural change and licking feet. O felt like the cause of the issue was not found and doesn't believe allergies are the cause as they have only come on the last year. However, o is keen to find underlying causeFor allergies, trial:Malaseb wash 2-3 times per week for 2 weeks, leave on for at least 5 mins before washing offTrial cytopoint to see if it gives him reliefCone on at all timesCortavance sid for 2-3 daysINI, revisit (at this point, explore Cushings as an underlying cause of contstant skin barrier dysfunction and recurrent infections, despite o saying bloods were normal at SASH, recc retaking bloods)Dear Erina, It was lovely to see you, Harry and little Sally today. Thank you for bringing him in and for updating me on how his skin has been progressing over the past year. I’m glad we were able to start treatment today, and I’m hopeful this will help make him more comfortable over the coming days. Please keep an eye on how his skin responds and let us know how he goes.Because Harry’s skin issues have developed later in life and have been ongoing for some time, allergies are one of the most common underlying causes we consider in dogs with chronic skin disease. In dogs, allergies usually show up as itchy skin. This itching can lead to redness, licking, chewing, ear infections, and secondary skin infections (e.g. the bacterial infection we diagnosed today).There are a few main types of allergies that can affect dogs:1. Environmental allergies (atopy): reactions to things like pollens, grasses, dust mites, or moulds. These are very common and can develop later in life.2. Food allergies: reactions to certain proteins in the diet. These can only be diagnosed through a strict diet trial.3. Flea allergy: even a single flea bite can cause significant irritation in sensitive dogs, so consistent flea prevention is very important. Harry is currently up to date with Bravecto Quantum which is great. Another thing owners sometimes notice with allergic flare-ups is behaviour changes related to discomfort. When dogs are very itchy or inflamed, they may seem more restless, pant more, appear lethargic, or be less interested in activities they normally enjoy, such as walks or play. This doesn’t necessarily mean something new is wrong,  often it reflects how uncomfortable they feel when their skin is flaring.Managing allergies is usually about long-term control rather than a permanent cure, and many dogs do very well once we find the right combination of treatments. Some common management strategies include:- Regular parasite prevention to eliminate flea allergy as a trigger- Medications to control itching and inflammation during flare-ups- Medicated shampoos or topical therapies to support the skin barrier (e.g. the Malaseb you have been using)- Diet trials if a food allergy is suspected- Identifying environmental triggers and managing exposure where possibleBecause allergic skin disease can sometimes be complex, I would highly recommend seeing the dermatology specialists at SASH Dermatology if Harry’s skin continues to flare or if we want to investigate things further. They have advanced testing and treatment options and can help develop a detailed long term management plan. I’m very happy to organise a referral if that is something you would like to pursue.Over the weekend, please keep monitoring Harry and how comfortable he seems following today’s treatment. If he were to deteriorate, seem significantly uncomfortable, or you were worried at any stage, emergency care again is always available for peace of mind while we are closed. Harry is a very sweet boy, and we’ll do everything we can to help keep his skin comfortable. Please don’t hesitate to reach out if you have any questions or updates.Dr Alice Gilmour DVMFigtree Veterinary Clinic    Vital Signs