C10013339 / invoice 10000

Reason: Urination Small Amounts, V OftenSubjective: - Increased frequency of urination, strong odour, straining with minimal urine output. Blood-stained urine noted two days ago. - Onset September 2025, resolved after one week with increased water intake. Recurred late November/early December 2025, intermittent since. Worst episodes: 20+ straining attempts during morning walks; currently 5–10 times. Blood-stained urine noted two days ago. Three urine samples collected today (07:30, 13:30, 15:30). - No prior urinary issues before September 2025. No previous antibiotic use. - Dental treats introduced around September 2025, ceased without resolution. Currently fed fresh chicken. - Overall active, eating, playing. Two to three days of reduced appetite in past month, coinciding with food change. No diarrhoea. Drinking normally. Licks vulva several times daily, briefly. No skin issues on body. Paws become red and inflamed, particularly after rain/wet grass; licks paws throughout the day, worse on rainy days. No redness on belly or chest.Objective: - Heart auscultation: normal. - Abdominal palpation: no obvious stones or grittiness palpated. - Vulva: very tucked in, possibly  prone to ascending infections. - Paws: mildly  inflamed, more prominent on hind paws than front. Photos from June showing significant redness. - Urinalysis (15:30 sample): 4+ blood, white blood cells, red blood cells, rod-shaped bacteria present. No crystals.Assessment & Plan:1. Urinary Tract Infection - Urinalysis consistent with UTI: bacteria, white blood cells, blood. - Amoxyclav prescribed, one week course. Administer with food to reduce GI upset. - No repeat urinalysis required post-treatment if clinical signs resolve (no straining, no blood). - If signs recur, urine culture via cystocentesis recommended. - Dilute chlorhexidine provided for daily cleaning around vulva to reduce ascending infection risk. Dilute to pale pink. Avoid eyes and mouth.2. Pododermatitis — Suspected Atopic Dermatitis - Paw licking and inflammation, worse on rainy/wet days. Likely environmental allergens (grasses, pollens). - Cytopoint discussed . Onset of effect expected within 2–3 days. Duration variable (1–3 months). Recheck when licking resumes. - Cortisone lotion discussed for use during flare-ups if paws become significantly inflamed. - Wiping paws with wet towel after walks recommended to remove allergens. Baby wipes acceptable for cleaning around vulva.Additional Notes: - Owner educated on UTI management, antibiotic administration with food, and monitoring for recurrence. - Owner educated on Cytopoint as maintenance therapy and cortisone lotion for flare-ups. - Owner advised to monitor for signs of antibiotic allergy (uncommon); GI upset possible if given on empty stomach. - Owner to monitor for return of urinary signs (straining, blood) and paw licking as indicators for recheck.    Vital Signs    Weight: 14.9;