C10016982 / invoice 10000

Reason: Growth On Lft ElbowAppointment Notes: Overdue reminders has growth on left elbow that flake keeps scratching at amd making it bleed. also wants to get flakes mouth checked as she poked a whole in it with a stick, jamie has had a chat with cpe and said they wern't concerned but still wants to get it checked. in with Jamie. requested MRP  ------- Sms reply: YPrevious known history: Apr 2023: Diet indiscretionJul 2023; DiarrhoeaNov 2023; Chin laceration 05/24; Wound below eye, sutured close 12/24; Nasal swelling, suspected cellulitis secondary to sunburn on nose03/05/2025 - Suspect DLE, ddx solar dermatitis, mucocutaneous pyoderma (less likely), neoplasia. Amoxyclav 2 weeks to RO mucocutaneous pyoderma (pathologists can confuse the two if there are bacteria present.16/05/2025 - Nose Biopsy And Scale & Polish ah, Suspicion for DLE with chronic nasal pyoderma, Cephalexin 450mg PO BID x 10d or until cytological resolution of infection Pred 1mg/kg PO SID - tapering in response to therapyCurrent Medications & Dose: Tacrolimus ointment SID to noseHistory (from Owner):   Appetite:  Diet:  Vomiting?:  Drinking:  Energy Levels:  Urine:  Faeces:  Vaccination Status:  Parasite control:  Microchip up to date?  How have they been since last visit?Lump behind L elbow, has been scratchign it and traumatising it. Moved into new rental recently, chewed up fly screen today. Examine:   Behavioural: Friendly girl   Mentation: BAR   Gait: Normal gait and posture Physical Exam (See Vital Signs): NAD unless otherwise stated    MM Moistness:   Skin Turgor:   Eyes:   Ears:   Nose:   Mouth:   Teeth: Moderate calculus on caudal upper arcades.    Lymph nodes:   Thoracic auscultation:    Pulse rate/quality:     Abdominal palpation:    Skin: Superficial wound L caudal bicep, moderate underlying swelling.     Musculoskeletal    Anal Sacs:    Reproductive:Assessment: Separation anxiety hightened with recently Wound behind L elbow.Treatment (See invoice items and client information): AB lotion topically to affected skin Trazodone 150mg PO SID 2 hrs before departing for work.Plan (See medication labels, reminders and instructions):R/V if no improvement of woundDental in next 6m.    Vital Signs    Weight: 17.3;