C10009849 / invoice 10000

Reason: PawsAppointment Notes: Overdue remindersHISTORY:Sunny presented with constant itching affecting left front paw and left back paw for approximately one week. Owner reports itching started following allergic episode. Constant licking behaviour observed, with bleeding noted two days prior to presentation. Pus-filled cyst-like lesion identified on penis area, appearing white and scabbed.Current meds: noneVaccination: overdue by one month, last vaccination February 2025 at Holland Park clinicParasite Prevention: NexGard monthly, worming tablets every three monthsPre-existing conditions: allergies, previously managed with Apoquel tabletsEXAMINATION:Cardiovascular: normalGastrointestinal:Abdominal: normalUrinary: pus-filled lesion on penis, cleaned and drained, exposed raw red skin underneathIntegument/Ears: right front and right back paws showing redness between digits, dried blood present from chewing behaviourDemeanour/Behaviour: alert and responsiveTREATMENT:- Cleaned penile lesion with antibacterial solution- Applied topical cream to affected areas- Elizabethan collar fitted- Annual vaccination administered- Apoquel injection given for allergy managementPLAN:- Maintain Elizabethan collar for 10 days until lesions heal and scab formation complete- Apply green topical cream to red areas, allow 5-10 minutes contact time before allowing movement- Monitor healing progress- Return for follow-up injection in one month if required- Continue NexGard monthly and worming tablets every three monthsCLIENT COMMUNICATION:Discussed ongoing nature of allergic conditions requiring maintenance therapy. Explained Apoquel injection provides one month coverage with 12-24 hour onset time. Advised strict cone compliance until complete healing observed. Demonstrated proper cream application technique. Owner counselled on monitoring for resolution of redness before cone removal.    Vital Signs    Weight: 5.8;       HeartRate: 29;       DentalGrade: 1;       RespirationRate: 28;       Temperature: 38.5;       CRT: <2s;       MMColour: P;       BodyScore: 4;