C10017550 / invoice 10000

Reason: Feels Hot Spot Is Coming BackHistory: Was looking good at end of ab course. Last few days started scratching LHS neck again. Started putting neocort on again and this has seemed to help. Has been a bit off his food but still eating. Not concerned about reduced appetite. No vomiting or diarrhoea. As afterthought - cut RF paw pad yesterday. Limping a bit. Clinical Signs: BAR. Nervous. OMM pink. Dental grade 0. Heart nad. LHS ventral to ear ~5x3cm oval yellow area with erythematous border. Not moist. Skin in this area mildly thickened. Ok with touching. Able to clip ventrally where looks like lesion extending. Cleaned with hexawash. LF main pad oval area where keratinised pad tissue eroded away. Flap of keratinised tissue caudally, underneath not full thickness. Lame 1-2/5 on LF. Assessment: 1. Incompletely resolved/recurrent pyoderma LHS ventral to ear. 2. Reduced appetite. Lost 1.5kg in 2 weeks. Ddx - antibiotic related? Other...3. Superficial ulceration LF main pad.Plan: Cephalexin 900mg po bid for 7d - ab change from amoxyclav in case it was responsible for reduced appetite. Macralone 40mg po sid for 3 days. Neocort BID for up to 14d. Chlorhex 5% sid and pat dry. Continue neocort and chlorhex after ab's finished and until lesion resolved. If not improving ok to email through photo. Panadol 750mg po bid prn for paw pad lesion. Expect flap to necrose/come away.    Vital Signs    Weight: 35.6;