C10005725 / invoice 10000

Appointment Reason: 1.2 CONSULT 2, Appointment Notes: Called to shuffle down to 2:30 or 5PM - bhPaws App Details:Booking Type: Consultation (Up to 2 concerns)Booking Notes: Skin Irritation on back right leg - red & loss of hair on spotOwner Are you a Pet Club Member?: NoOwner Are you interested in learning more about our Pet Club?: NoPet Insured: YesVET:Dr Liz ClarkeHISTORY-   Presenting complaint: Licking a spot on the back right leg for a couple of days. This has become progressively worse, particularly over the last 24 hours.-   Relevant past history or medical conditions unrelated to todays presenting complaint: No previous skin issues. Has recently been visiting a new forested park in the last week.-   Preventatives: NexGard spectra -   Diet: Commercial kibble-   Medications: None-   Lifestyle: Indoor dog, sleeps on bed/lounge.EXAMT deferred, HR 120bpm, RR normal, MM Pink, CRT <2s, BCS 5/9-   General – BAR-   Eyes - NAD-   Ears – NAD-   Nose - NAD-   Heart sounds - SSFP, no murmur-   Thoracic auscultation - NAD-   Urogenital - NAD-   Lymph Node Palpation - NAD-   Skin and coat - Ulcerated, swollen, non-painful lesion on the caudal right hock -   Musculoskeletal and Gait Examination – NAD-   Neurological Examination - Normal mentation, no obvious deficitsDIAGNOSTICSNILASSESSMENTProblems list1.  Acral lick dermatitis right hindlimbDDx: Allergic reaction, trauma, foreign body, pressure sore, neoplasia.OWNER COMMSDisc performing cytology ($48) on the lesion to investigate further. Owner declined and elected for empirical medical management. Disc importance of lick prevention and use of an e-collar.TREATMENTS-   Pred 5mg: 1 tablet PO SID for 4 days, then 0.5 tablets PO SID for 2 days.-   Neocort cream (tiny bit dispensed): Apply a small amount topically to the lesion BID for a few days.PLANRevisit if the lesion is not improving or worsens, or lameness occurs E-collar on at all times to prevent licking.    Vital Signs    Weight: 6.8;