C10021251 / invoice 10000

eyes swelling up, o thinks poss allergic reaction
coming from parkhurst

HISTORY
Presenting for: French Bulldog presented for acute facial swelling that developed over the last 15 minutes
Historical Conditions: Skin allergies, chronic anal gland issues (last seen June 2025 for anal glands), currently on immunotherapy
V/D/C/S: No vomiting or diarrhoea reported
Skin: History of skin allergies, patient was scratching his face just before swelling developed which is unusual as scratching has improved since starting immunotherapy
Current Meds: Immunotherapy only
Other: Owner noticed scratching behaviour followed by rapid progression of swelling affecting left eye, right eye and lips within minutes, suspected insect sting (bee or wasp) as trigger

EXAM
Mentation: BAR, hyper as usual
Wt: 19 kg
T: 38.9°C (normal, under 39.05°C)
MM: Pretty good appearance, gums are pigmented/dark coloured but appear normal, possibly slightly bright due to examination lighting
Behavioural: Very social, readily accepts treats during examination, strong and active
Cardiovascular: Chest sounds good
Integumentary: Significant facial swelling affecting both eyes and lips, more pronounced on right side but some involvement on left side. Pink, thickened skin noted in inguinal region where testicles would be located - appears scratched or irritated, not typical appearance for this patient

ASSESSMENT
Acute allergic reaction - likely insect sting (bee or wasp) based on rapid onset and facial distribution of swelling

PLAN
Medications/Treatments:
- Antihistamine injection administered subcutaneously
- Steroid injection administered subcutaneously in neck region for stronger anti-inflammatory effect given breed-related breathing concerns

Additional Discussion:
- Monitor for reduction in facial swelling over next few hours
- Ensure patient maintains normal eating and drinking ability
- Restrict water intake to small amounts initially to prevent vomiting
- Keep patient in air conditioning and comfortable
- Monitor breathing closely given French Bulldog breed predisposition to respiratory issues
- Observe unusual inguinal skin changes noted during examination

Client Comms:
- Owner working from home today for close monitoring
- Watch for any breathing difficulties, vomiting or diarrhoea
- Patient may be less active than usual due to steroid injection
- Strong medications given to prevent respiratory complications
- Weekend monitoring planned with owners at home