C10010989 / invoice 10000

History: rash on the back of his neck, noticed today. Just moved house, concerned for allergy in new location. Otherwise well. No Hx of hotspots before from previous history Examination:BEHAV: 		BAR, FAS 2-4/5 -- got grumpy when we tried to clip his hotspot. Mostly just tried to get away from us until we persisted and then he started bearing teeth and snapped. Listened to him and left him alone after that CARDIOVASC: 	Not ausculted RESP: 		Rate and effort ORAL: 		Teeth not examined EYES: 		Clean and clearEARS: 		Canals red from a distance -- unable to do aural exam as he was too worked up when we tried LYMPH NODES: 	Submandibular, prescapular, and popliteal all palpable WNL INTEGUMENT: 	Hotspot on the back of the neck, from left ear to just before the right ear. ABDOMEN:	Comfortable on palpation. No abnormalities detected.  MSK: 		Ambulates well. Full MSK exam not performed. NEURO: 		Normal mentation and gait. No suspicion of CN deficits. Assessment: Problems 1. Hotspot on the back of the nek Client communication: explained to owners that I would ideally like to clip the area and clean it with malaseb but he won't let me. Will start on meds and then we can try again when we take the pain out of it with apoquel, or see if we can get on top of it without topical treatment for now. If not working, may need sedate him and clip the area in order to give it a good wash Explained possible allergic component, but would be more suspicious about the wet weather we've had and the skin not fully drying. Atopy/contact allergies can make hotspots more common so we can't rule it out, but this alone doesn't necessarily suggest he has allergic skin disease (at least at this time) Meds/Product Dispensed: 1. 28.00 x Apoquel 16mg chew (Oclacitinib)    Give ONE (1) tablet TWICE daily for 7 days, then reduce to ONE (1) tablet ONCE daily2. 28.00 x Cephacin 600mg tab (Cephalexin) (300)    One (1) tablet twice a day. Give until finished.Plan: Treatment as above. Revisit in 1 week, sooner if getting worse. Will consider vaccine at next visit    Vital Signs    Weight: 28;       DentalGrade: 0;       RespirationRate: Pant;       PainScore: 0;       CRT: < 2;       MMColour: PInk ;       BodyScore: 5;