C10008824 / invoice 10000

Species:CANINE
Breed:Maltese Cross
Age (years):3
Diagnosis or signs:Skin
Consult notes
10/03/2026 Reason: Revisit nose

Hx:
See prev hx, improved marginally on topical corticosteroids but has since worsened. crusting on nasal planum extending up to top of head now. Some self trauma around perianal region too.
Otherwise well. EDDU normally, BAR, no vomiting or diarrhoea, owner has n other concerns

Ex:
TPR all normal
Dark crusting over nasal planum, pink raw skin underneath.
Painful to palpate.
Perianal region slightly reddened, far less scabbing.
Rest of physical exam unremarkable.

Ax:
Possible lupus?
other skin dx

Px:
Discussed with owner may eventually need skin biopsies
trial 10 days doxycycline + niacinamide. review if not resolved.

Animal clinical history (3 most recent)

2026-02-26T00:00:00Z 11:24:07
Booking reason: Sore nose not resolved.
Owner called and cancelled appt @11.18am that was booked for today as she is unwell.
2026-02-02T00:00:00Z 13:21:02
Dry and crusty skin from nasal planum extending up bridge of muzzle to almost between eyes. 
Started about a month ago just on nasal planum area, near junction of haired skin, some slight discolouration. 
Progressed up along bridge of nose over the last few weeks and not crusty and scabby feeling. 
Not pruritic, Belinda very observant and has not noticed Tillie rubbing or scratching at her nose once. 
Otherwise well, EDDU fine, no other issues. 
Rest of skin wnl.
Loves sun baking. 

Exam:
used moist cotton wool ball to wipe away some crust, looks a bit like flea dirt stuck in fur
skin underneath mildly pink, but not painful
dried and coved with light amt neocort

Ddx: dermatitis/irritation secondary to trauma from digging, chasing ball, rubbing nose under a fence etc although O reports none of these things really fit. Also need to consider auto immune disease, lupous, or bacterial dermatitis possibly. 
Plan:
trial topicals for now, can use very dilute malaseb to try to remove crust, pat dry and neocort or similar. Consider abs and/or pred going forwards, or doxy, niacinamide and other topical corticosteroids. 
2026-01-29T00:00:00Z 12:51:22
6 comb body, scissor the head, left ears to keep growing out and tidied tail 

Previous claim history (5)

DateClaim #Diagnosis
2025-10-05C9311907VOMITING - OTHER - PRESENTING COMPLAINT
2025-08-21C9122064VACCINATIONS OR HEALTH CHECKS
2024-12-13C8078270PAIN - OTHER - PRESENTING COMPLAINT
2024-09-02C7657976VACCINATIONS OR HEALTH CHECKS
2024-02-05C6842722COLITIS

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

LinetstarcAmountDateUpstream diagnosis
10000tstarc_antibiotics_-_doxycycline25.402026-03-10
20000tstarc_consultation-revisit114.002026-03-10

UPM+

  • DG02124SKIN (CUTANEOUS) ABNORMALITY - OTHER - PRESENTING COMPLAINTDSTP_skin_-_dermatitis

Variant (sleepy_king)

DERMATITIS
DSTP_skin_-_dermatitis
Conf: 0.850
Threshold: 0.25
Above:
Correct?