C10014238 / invoice 10000

Reason: Skin Check Appointment Notes: Overdue reminders-ksClient Concern: History: had dental 6/3 and no teeth extracted but oronasal fistula repair done. He does sneeze a bit, no nasal discharge though. Still on soft food. Skin - had some areas of rash on back checked at time of dental, since then it has progressed and has patches of alopecia along sides. Owners originally thought it may be related to a shampoo or spray used by groomer, but it has been a month since grooming now so O doesn't think this is likely related. Has been using malaseb wash and topical neocort but not really improving. Physical Examination: Patches of alopecia on dorsum and body walls laterally. Mild erythema inguinal skin. Oral exam - still a small 1-2mm defect present that hasn't healed over at site of oronasal fistula. Sutures are still present in gingiva but rest of site has healed well.   Assessment: small fistula remains - likely will cause some mild irritation/sneezing ongoing. We expect another dental to be done next year, can attempt to repair this small defect again next dental if still remains then. Until then will likely have some mild ongoing rhinitis. Skin - appears to be worsening allergy signs. Owner happy to trial cytopoint. Treatment: gave cytopoint 20mg - 2mg/kg explained this is off-label dose but safe. Plan: if skin settles, then watch for pruritis returning and can repeat cytopoint as needed. Recall/Revisit/Remind:    Vital Signs