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Primary Presenting Complaint:Acute unilateral (L-sided) facial swelling progressing to bilateral involvementOther Complaint:Chronic environmental allergies (pedal, otic)History:Allergies affecting feet and ears historically. Never experienced facial swelling previously. Recently introduced goat protein (half portion) mixed with turkey approximately 24 hours prior to symptom onset. On K9Q gut protect and PEA plus for approximately 3 weeks for allergy management. Previously on Protexin probiotic which was more effective.- Medicine Hx - Current: Cetirizine (Zyrtec) PRN for acute reaction - multiple doses given in past 24 hours. K9Q gut protect probiotic x 3 weeks. PEA plus x 3 weeks. Previous: Protexin probiotic (discontinued 3 weeks ago)- Diet - Turkey-based diet. Recently introduced goat protein (half portion mixed with turkey) approximately 24 hours prior to presentation. Known intolerances to chicken and beef.Examination:Acute hypersensitivity reaction with marked facial oedema, partial response to antihistamines, requiring corticosteroid intervention- Attitude - BAR, uncomfortable due to facial swelling and pruritus- Body Score - 5/10- Hydration status - normal- Temperature - not taken- Heart - HR. Murmur - none HR 100- RR - panting- Dental - Score(0-4)= 0-1- CRT - immediate- Eyes - No abnormalities noted- Ears - History of allergic flare-ups, currently well-controlled- Abd Palpation - Unremarkable- Gastrointestinal - Yellow powdery material noted in faeces since starting K9Q gut protect, suggesting rapid GI transit and inadequate digestion of probiotic- Urogenital - No Sig Findings- Skin - swelling left side of muzzle, no stings located, uncomfortable in this area- Musculoskeletal - No Sig Findings- Neurological - No Sig Findings- Lymphatic - No Sig Findings- Other Key Findings - Marked left-sided facial oedema with lesser right-sided involvement. Dysphagia and throat irritation noted during peak swelling overnight. No visible wounds, penetrating injuries, or foreign bodies identified on examination.Assessment:Acute type I hypersensitivity reaction with inadequate response to antihistamine monotherapy, requiring corticosteroid interventionProblem List:1. Acute bilateral facial oedema (L>R) with partial response to cetirizine2. Pruritus and discomfort associated with facial swelling3. Dysphagia during peak swelling episode4. Chronic environmental allergies (pedal and otic)5. Possible probiotic malabsorption evidenced by undigested material in faecesDDx:Acute facial swelling DDx:- Insect envenomation (bee/wasp sting)- Type I hypersensitivity to novel protein (goat)- Contact allergen exposureChronic GI signs DDx:- Probiotic formulation incompatibility- Rapid GI transit time- Inadequate probiotic digestionDiscussed:Owner consented to short course of corticosteroids (prednisolone) for 3 days to manage acute hypersensitivity reaction. Discussed potential side effects including PU/PD, polyphagia, and possible GI upset (v/d). Owner advised to discontinue goat protein and return to previously tolerated turkey diet. Discussed reintroduction trial of goat protein in several weeks with  cetirizine and prednisolone administration if allergic reaction. Owner educated that facial swelling in allergic reactions can occur regardless of bite/sting location. Discussed that single exposure to novel protein insufficient to definitively diagnose food allergy. Owner advised to consider switching back to Protexin probiotic given better historical response and current evidence of K9Q gut protect malabsorption.Treatment Plan:1. Prednisolone PO for 3 days to manage acute hypersensitivity reaction2. Continue cetirizine as needed for antihistamine effect3. Continue PEA plus supplementation4. Discontinue K9Q gut protect, consider returning to Protexin probiotic5. Eliminate goat protein from diet, return to turkey-based diet exclusively6. Dispense one additional prednisolone tablet for emergency use or prophylactic administration during future goat protein reintroduction trial7. Monitor for adverse effects (v/d, excessive PU/PD, polyphagia)Ongoing Prescriptions:PEA plus - continue current regimenNext Visit:Recheck PRN if swelling recurs or worsens, or if GI signs develop. Plan to reintroduce goat protein in several weeks with prophylactic antihistamine and corticosteroid coverage. May dispense medications without consultation if similar reaction occurs within next few weeks.The above clinical notes were created with the assistance of Astro Scribe under the supervision of the consulting Vet.Checked by HB