C10011646 / invoice 10000

Primary Clinician: STTLast Appt: 29.01Previous Plan (copy from hx notes):Assessment:Suspect contact allergy with secondary dermatitisTx:Isaderm cream BID for 7-10 daysPlan:Follow up call on mondayINI then consider oral abs but I would prefer not to.Owner Communication: (incl name of owner spoken + time called): KAW spoke to Hector at 10:51am, skin is improving with isaderm application, less red and irritated. Will complete the weeks worth of application and call if concerns not resolved.

Reason: Check skinHx: Presented by Hector and JessicaBIOP since a pup- Am Staff X. Had sx on elbow for elbow dysplasia and also RHL TPLO years ago.Is on dry food and fresh kangaroo mince. O has lapsed in his F+W as he has had GI signs with a monthly preventative in the past- O Will try again.A few months ago he had urticaria on his head and it was very puff- had anti histamines which helped.Since then O has noticed intermittent bumps on his body. He's not overly itchy, just occasional itching but no obvious paw licking. Os go to the same park every day, Os do have a backyard that he hangs out.Last few weeks -O noticed that there has been lumps on Chico's L lateral stifle. He does occasionally chew at it but not overly.Ex:BAR, nice dog, LOVES treatsMM p crt <2sTeeth G0HR 108RR 20BCS 7/9- better at 28kgAbdo palp NADLNs: L poplitheal subjectively a bit larger than RSkin on L lateral stifle approx 50c sized are of dermatitis: tape prep showed neutrophils with occasional cocciAssessment:Suspect contact allergy with secondary dermatitisTx:Isaderm cream BID for 7-10 daysPlan:Follow up call on mondayINI then consider oral abs but I would prefer not to.Communication:asked O if they would like meds to reduce itching (ie apoquel)- O declined for now as he doesnt seem too bad.O will restart a monthly preventative- gave product names (simparica trio, NGS, credlio plus)

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