C10011558 / invoice 10000

Reason: Skin Conditon - Not Getting Any BetterHistory:BIB female owner.O reported that the skin lesions did not look as bad as before but didn't improve further, it did look better briefly and dry but keep reopening it then get irritated again. Never had this type of irritation before.EDDU normal. No V+, D+. Goes and toilet outside during the day. UTD w/ flea prevention.No recent change at home that could stress. Current med: Pred 1mg EOD last couple days - O gave it with creamy treats. Convenia given on 27/02. Examine:BARMM pink/moistEyes - clearEars - clean. Dental grade - 0.5-1/4HR=PR= 178 Grade IV/VI murmur. All lung fields sound clear. Normal REAbdomen soft and comfortableSkin - - Erythematous and scabby lesions on both temporal skin - Multifocal erythematous rashes on base of ear on hairless region - worse on R side. - No erythema under lips- No erythema on ventral body.Both submandibular LNs still mildly increased.  Ambulatory - no lameness or ataxia, full ortho exam not performedCytology of temporal skin + ear base - patchy degenerate neutrophils, no intracellular cocci. Clusters of malassezia 4-6 hpf. Assessment:- Multifocal erythematous skin lesions - both lips and ventral body have resolved. However temporal skin and base of ears remain erythematous and scabby. - Cytology shows concurrent malassezial infection which would explain lack of improvement with current tx. - Cannot rule out underlying allergies causing secondary infection - ddx: food, atopy. Treatment:- Panapex on temporal skin and ear base BID for 7-10d- Ecollar to prevent rubbing/scratching Plan:- Apply new topical treatment BID on affected areas- Use of a soft E-collar recommended to prevent licking/scratching of the treated areas- Keep Dustin indoors to avoid complications with the E-collar- Recheck in 7 to 10 days if no improvement.- Consider long-term management strategies if symptoms persist or recur - antihistamine? Low dose steroid (but increased risk of CHF given his underlying HCM). --- 09/03/2026 18:14:10 OSG:O came back in to get a smaller coller, last one came off straight away. Credit on file to be used for next appointment    Vital Signs    Weight: 7.16;       

Reason: Cat Fight Whilst O Was AwayHistory: O away 2 nights. Only just arrived home. Prior to O going away he was totally fine. O hasn't spoken to neighbour yet, not sure when it happened. Daughter saw Dusty scratching at himself this afternoon.  Examine: BAR, mm pink moist CRT<1s. HR200 grade 4/6 SHM. RRwnl normal effort. Abdo palp comfortable. Submandibular lnns slightly enlarged. Bilateral pre-auricular skin inflamed and self trauma scratches. Scoped both ears, clean to TMs bilaterally. Small area of erythema/ alopecia on ventral chest. Lips mildly erythemic also. Weight loss - has been on weight loss food because of other cat. Assessment: pyoderma mostly on faceTreatment: convenia inj 0.7ml SCPlan: pred 1mg PO BID for 3 ays then taper. First dose given tonight. O has difficulty medicating and we don't have predmix in stock. Advise crush tablet and mix with creamy treat. Revisit if needed.    Vital Signs    Weight: 7.07;       

Reason: Meloxicam    Vital Signs