C10010364 / invoice 10000

Appointment Notes: Bentley (Dog) - Consult: Skin or Ear Issue [Clinician : Dr. John Thirlwell(No Preference)] - Skin irritation under front legs - Web BookingClient name: Bambi ColemanContact number: 0416259671Email address: bjc7@live.com.auPatient name: BentleySubjectivePresenting Concerns:  Bentley presented for examination of licking and hyperpigmentation in the axillary regions, which has been ongoing for several weeks and has worsened over the last 10 days.    Historical Conditions:-   History of previous skin issues that were responsive to Apoquel.  Diet/Appetite:-   Fed a mixed diet of Prime100 Crocodile, cooked vegetables, and cooked beef mince.  Skin & Coat:-   The owner reports persistent licking of the underarm area, which has become darker. Applying cream seems to encourage more licking.-   The owner also notes the skin on the belly has become mottled.  Lifestyle Risk Factors:-   Shares bedding with another dog that reportedly has a resistant staphylococcal skin infection.ObjectiveMentation: BAR  Wt: —  BCS: --/9  T: Not taken  P: —  R: —  MM: pink/moist. CRT < 2sec.  Hydration: Normal    Emotional Assessment: —    Eyes: Clear. No discharge or erythema OU.  Ears: Clean with no discharge or erythema AU.  Nose: Clear, moist without discharge.  Throat: No inducible cough upon tracheal palpation; no palpable masses.  Oral: Calculus and gingivitis absent. No masses or other lesions.  Cardiovascular: No murmurs or arrhythmias, strong synchronous pulses.  Respiratory: Normal bronchovesicular sounds bilaterally.  Abdominal: No organomegaly or mass effects. No pain on palpation.  Lymph Nodes: No peripheral lymphadenopathy.  Integumentary: Hyperpigmentation is present in the axillary regions. The ventral abdomen has mottled pigmentation. A soft, mobile SQ lipoma is palpated. No evidence of active infection.  Neurologic: No ataxia, normal mentation.  Musculoskeletal: Ambulation normal, no lameness observed.  Urogenital: Normal external anatomy.  Rectal: Not performed.AssessmentPruritus – Suspected allergic dermatitis causing licking and secondary hyperpigmentation. No clinical evidence of secondary pyoderma.PlanMedications/Treatments:-   Apoquel: Dispensed. Give 1 tablet PO BID.  Diet & Feeding Recommendations:-   Discussed alternative diet options, including Prime100 casserole-style foods.  Additional Discussion:-   Advised to monitor for resolution of licking. Recheck if the condition does not improve.-   Recommended discontinuing topical therapies to avoid encouraging licking behavior.    Vital Signs    Weight: 7.9;