C10005795 / invoice 10000

09/03/2026 Presented for skin irritation on feet. PB

HISTORY: O noticed that for the last few months Peaches has had a skin irritation appear on and off on her feet and under her chin. O's weren't sure if it was an allergy of some kind, otherwise well eating and drinking normally, and no V+ or D+. PB

PHYSICAL EXAM: 
Attitude: BAR
BCS: 3/5
Heart/lungs:  no heart murmurs or arrhythmias auscultated. Lungs clear bilaterally. 
MM: pink, moist CRT < 2 sec 
Skin Tent: normal
Dental Score: 0 however large overbite present. Neither mandibular canines or incisors are making indents into the hard palate or making conct with other teeth. No irritation noted.
Abdomen: normal
Skin: erythema, flaky skin on all 4 paws ad rostral muzzle.
Eyes:clear, normal
Ears: clear, normal 
Temp: N/A
Lymph Nodes:
MSK/Neuro:
Rectal: N/A

DIAGNOSTICS:
Skin cytology: yeast ++  cocci +

ASSESSMENT: Superficial mixed bacterial and yeast dermatitis on paws likely secondary to contact allergy or atopy.

PLAN: 
Topizole wash q2-3d with 10 min. contact time for 2 weeks.
Cephalexin PO BID for 7d.
Cytopoint SC. 
Advised to apply QV cream to paws to help with skin barrier.
Recheck in 2 weeks.
Advised overbite present, but not currently causing issues with indention or ulcerations/inflammation.

LV