C10004556 / invoice 10000

Reviewer

Species:CANINE

Breed:Boston Terrier

Age (years):4

Diagnosis or signs:Skin

Consult notes

<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div>
<div>
<div>
<div>
<div>
<p><strong><span data-contrast="auto"><span style="font-weight: 400;"><span style="color: #ff0000;">Have reminders been checked? Y/N</span><br><span style="color: #ff0000;">Has the owner been advised of this? Y/N</span><br></span><br>GapOnly claim Insurance Summary<br>First Clinic Signs: 4 days ago<br>Diagnosis/Suspected: Allergic dermatitis<br>Summary/Suspected Cause: As above<br>Any other conditions being treated/known health concerns(if any): No<br>Treatment/Plan: </span></strong>Malaseb 2x a week and alooven conditoner. Apply neocort to lesions (no longer than 14 days).  <strong><span data-contrast="auto"><br></span></strong><span data-contrast="auto"><br>Presented for Skin flare up.</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><span data-contrast="auto">Hx: </span> <br><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'>Stayed at someone else house for 2 days, O came back yesterday and she had red lesions over her stomach and on her sides. She was outside a lot (long grass, and lots of plants, etc) and she was not having neocort applied to body (just face folds). She hasn't been licking, chewing at lesions, just <br><br>s in sopmeone elses care for 2 of these days - outside a lot here and neocort was not being used. Not scratching or licking these lesions, other than face folds. <br><br><br>Bathe once a week with malaseb and alooven - has been working well. Neocort everyday in which part that were needed. Cytopoint injection working well. Before went away skin was looking good - was scratching at face fold.</span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><span data-contrast="auto">General Hx:</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<ul>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">EDDU?</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Any changes?</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Lifestyle/other animals:</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Diet:</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Para:</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Meds: </span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Access to toxins?</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
<li data-leveltext="-" data-font="Calibri" data-listid="3" data-list-defn-props='{"335551671":0,"335552541":1,"335559684":-2,"335559685":1080,"335559991":360,"469769226":"Calibri","469769242":[8226],"469777803":"left","469777804":"-","469777815":"hybridMultilevel"}' aria-setsize="-1" data-aria-posinset="0" data-aria-level="1"><span data-contrast="auto">Other concerns?</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></li>
</ul>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><strong><span data-contrast="auto">PE:</span></strong><span data-contrast="auto"> </span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Cardio: Regular rate and rhythm, no murmur detected. </span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Resp: No wheezes or crackles auscultated</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Oral: CRT &lt;2s, pink and moist MM. Dentition </span><span data-contrast="auto">GRADE</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Eyes: Bilaterally symmetrical,  clear and no presence of discharge</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Ears: No erythema or discharge noted</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">Integument: NAD</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">GIT Palpation: Abdomen comfortable on palpation, no obvious masses</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> <br></span><span data-contrast="auto">MSK: Comfortable on flexion and extension. No lameness noted.</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><strong><span data-contrast="auto">Assessment</span></strong> <br><span data-contrast="auto">     </span><span data-contrast="auto">Ddx:</span><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><strong><span data-contrast="auto">Treatment</span></strong><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<div>
<p><strong><span data-contrast="auto">Plan</span></strong><span data-ccp-props='{"201341983":0,"335559739":160,"335559740":259}'> </span></p>
</div>
</div>
</div>
</div>
</div></html>

Animal clinical history (3 most recent)

2026-02-20T00:00:00Z 15:58:00

Presented for skin irritation. Went swimming recently. Gets skin issues fairly regularly but has had a big flareup. Seasonal irritation. Has used cytopoint in the past and worked for a short period. Cannot tablet, liquids difficult, injection preferred. EDDU, no vx/dx, no other concerns. Malaseb 1-2x weekly, no shampoo. Gut probiotic, omega 3's.PE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Dentition g1Eyes: Bilaterally symmetrical,  clear and no presence of discharge Ears: No erythema or discharge noted Integument: Regions of 5mm-1cm large dried scabbing lesions and areas of alopecia. Erythema and crusting under chin and in skin folds. Small 2mm round raised red lesion on the ventrolateral margin of the L-eye - has a hair ingrown in the centre, expressed pus from massGIT Palpation: Abdomen comfortable on palpation, no obvious massesAssessment Allergies - environmental, contact, atopy vs excessive humidity/moisutreDiscussed treatment options. Lesions healing well with topical solutions. Would recc. cytopoint to reduce itching/scratching. If lesion by eye does not reduce in a short time frame would recommend removing under a GA - can send for histopathology. Too close to eye to sample. Gave option of short-term steroids but too hard to give PO meds.Treatment Cytopoint 20mg SQ Neocort PRNIntroduce aloveen conditioner to malaseb routine Trimmed nails

2025-11-21T00:00:00Z 08:15:00

Have reminders been checked? Y/N DotodayGapOnly claim Insurance SummaryFirst Clinic Signs: Tremoring q3m, due annual injections, lump on chestDiagnosis/Suspected: Neurological (vs spinal) open Dx, benign vs malignant lump Summary/Suspected Cause: Open diagnosisAny other conditions being treated/known health concerns(if any): NoTreatment/Plan: FNA lump, neocort lotion, C5 + SR12 + BQ + discuss neuroPresented for vaccination + SR12 + BQ. EDDU. No Vx/Dx notedPara: Very difficult to tablet, due endogard today. Tried to give in consult but Billie has a very solid jaw and accidentally bit me. O's can use q6-12m if unable to give at home. Meds: noConcerns: Lump on chest, unsure if due to harness rubbing? Consented to FNA. Shaking episodes from 5.9.24 have been occuring 3x a year still. O presented video of Billie full body shaking, eyes are in a straight-forward position, does not respond/move towards O's when speaking to her. Shaking occurs for a few minutes and then B settles within 20 minutes. Cannot walk during event. No other signs seen outside of episodes, no apparent post-ictal phase according to O's. PE: Cardio: Regular rate and rhythm, no murmur detected. Sinus arrythmia, normocardic. Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Dentition g1Eyes: Bilaterally symmetrical, clear and no presence of discharge Ears: No erythema or discharge noted Integument: R-side neck 2mm red raised bump FNA - WBC +++++, possible round cells mixed in with inflammation, too much contamination to assess Apply neocort to wound TID for 7dIf mass increases in size, becomes ulcerated, changes morphologically or persists would recc. retestingVideo of episodes appears neurological. Advised next step in work-up is to proceed to MRI +- CSF tap. O's aware of costs associated. Have opted to monitor at current and will proceed to referral if symptoms increase in frequency, severity, or other clinical signs are noted. Plan: Vaccinated with C5 + SR12 + BQDue 21.11.26Endogard given to O's to give at home (Do NOT try to tablet in future, very difficult to do)

2025-04-23T00:00:00Z 12:56:00

Have reminders been checked? Y NoneGapOnly claim Insurance SummaryFirst Clinic Signs: 10dDiagnosis/Suspected: otitis externa Summary/Suspected Cause: malasezziaAny other conditions being treated/known health concerns(if any): nilTreatment/Plan: dermotic BID for 7d, pred tapering for 10dHx:O noticed her scratching her ears about 10d ago, shaking a bit too. Had an ear infection 1.5yrs ago. Otherwise wellEDUU wellO pretty sure utd preventionsnot on any medicationwould also like nails trimmedPEx:BAR, mm pk+m crt<2sec. ENT wnl. R ear moderately erythematous, L mild. Cardiac ausc wnl. Lung sounds clear. Abdominal palpation soft and comfortable. Ambulating well. WBx4. LNs wnl. skin on muzzle and between toes also mildly erythematous. OverweightEar swabs:Malasezzia +++ R ++LDx: bilateral otitis externaTx:Nails clippedPlan:Pred 5mg PO SID for 5d then EOD for 5dDermotic BID for 7dDiscussed weight, aim for 9kg

Previous claim history (2)

Date	Claim #	Diagnosis
2026-02-20	C09933784	HYPERSENSITIVITY DISORDER (ALLERGY)
2021-11-30	C4288985	VACCINATIONS OR HEALTH CHECKS

Line items(lines with upstream diagnosis are skipped by the model)

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_consultation	97.00	2026-03-09	—

UPM+

DG02319HYPERSENSITIVITY (ALLERGIC) SKIN DISORDERDSTP_skin_-_allergic_disorder

Variant (sleepy_king)

HYPERSENSITIVITY DISORDER (ALLERGY)

DSTP_skin_-_allergic_disorder

Conf: 0.350

Threshold: 0.38

Above: ✗

Correct?

Yes No