C10020625 / invoice 10000

History: 
in for recheck of lesion LH 
o advised when she was on prednisolone she was no longer licking at it 
swelling has now resolved but yesterday she was chewing at the skin in area++
red lesions have come up on her neck -  o thinks she is scratching at them 
has finished pred & antibiotic course 

ce:
HR regular, no murmurs 
resp ausc- nad 
comfortable on abdo palp, abdo soft 
Integ: 
dorsal neck both sides- round inflamed red lesions & surrounding skin also mildly inflamed 
left hindpaw- lateral aspect d4- swelling now resolved & most of skin healing well however inflamed triangular shaped area in the centre with some mild oozing on surface of skin 

Assessment:
ongoing/recurrent pruritus - discussion with o that most likely underlying allergy trigger (food vs environmental) with 2ndry skin infection 
discussed pred course for short term use & if keeps recurring (ie licking paws, inflamed lesions) then need to consider longterm maintenace therapt (cytopoint vs apoquel discussed) 

Treatment:
Pred 2.5mg PO BIDX 5DAYS then pred 2.5mg PO SID x5 days then pred 2.5mg PO EOD to finish course
cephalexin 100mg PO BID x7 days 
neocort to inflamed area


Plan: 
recheck if recurrence following course & next step is cytopoint or apoquel longer term if indicated