C10017614 / invoice 10000

Reason: RashAppointment Notes: Overdue remindersHistory:Got from kennel yesterday. Noticed rash yesterday. At kennel for 5 days. Didn't know what kennel fed her.Face rash - some around eyes, lips, muzzle, nasal planum. Scratching face on carpet.Left a bit of her brekky this morning, not like her. Slightly soft stools.No puffiness or struggling to breathe. Groomed at groomer.Runny poos with chicken.EDU okay. No V/D/C/S.Current diet: Blackhawk. Raw and dry. Chicken, lamb, beef.Current medications: NoneParasite Control: Nexgard Spectra - just before heading to kennels.Objective:Mentation: BAREENO: Eyes clear, ears NAD, mild erythema and small bit of bleeding on L aspect of nasal planum, mild periodontal diseaseLNs: NADHR: heart sounds good, no murmur or arrhythmia detectedRR/RE: Normal effort, clear lung sounds bilaterallyCRT: 1.5s  MM: p/mAbdomen:Tense but comfortableIntegument: Two small, slightly raised reddened lumps around R eye and one around L eye. Some crusting and erythema noted on bottom jaw, rostrally as well as along the lips. Nasal planum redness. Some crusting along neck and chest. Erythemic, saliva stained paws. Saliv stained fur around anus.Assessment:Likely food allergy related skin flare up. Owner suspects chicken - has always had soft stools when had chicken.Small, raised lumps on face - suspect food allergy vs canine papillomavirusPlan:Change diet to single protein hypoallergenic. Advised using Prime100 with a protein that is very different to chicken - try salmon or kangaroo or croc. To also go on hypoallergenic RC dry. Owner wants to have a think and will likely get food from pet shop.Advised to monitor for increased itchiness or redness - bring back in to manage it, otherwise wait for 6-8wks for RV.Also monitor lumps around eyes.    Vital Signs    Weight: 18;