C10027491 / invoice 10000

History:Seen 24th Jan due to a dermatitis/scab on the back of his neck. Examination was difficult due to his nature.Trialled dilute chlorhex bathing BID - patient did not tolerate.O then Requested Abs: Cephalexin 500mg PO BID x 7dd - just finished course.Initially the area seemed to respond, but in the last few days it has spread to a new area & seems worse.He is pruritic in that area.EDDU normal.Examine:Impossible - patient is very anxious, avoidant & became mildly aggressive.Rx sedation due to his temprement - O agreed.Dormosedan gel 0.5mL applied orally by O - unsure how much he actually received.Adequate for top up: Gave Butorphanol 0.3mg/kg (0.8mL) + Medetomidine 5ug/kg (0.15mL) IM. Tolerated fine with blanket over his head.Adequate sedation.PE under sedation:HR/PR = MM = p/m CRT <2s.Auscultation: Normal, no murmur or arrhythmia.Abdo: Soft, no palpable issues.Bcs: 3/5Oral: G1 dental upper canines & upper/lower PM's & M's. Nil gingivitis.Peripheral LN's: WNLEars/paws: NADSkin: Focal ~3x3cm area of crusting dermatitis dorsal surface of the base of the neck with underlying erythema.Cytology skin lesion: Cocci ++ ~10/pf, neuts +++++++, occ RBCTmt:Clipped & cleaned skin area with dilute chlorhex.Applied Neocort.Gave Antisedan 0.2mL IM, will allow to spontaneosuly recover granted nature.Plan:D/c this afternoon.Extend course of Cephalexin: Increase to 600mg PO BID x 14dd. R/c INI.If O can apply neocort, will dispense also - O advised not possible.

o said cant clean itWill dispense course of Ab's to cover for infectionmonitor othewise.Cephalexin PO BID for 7 days.

Dog has small scab on neckBut O cant touch itis very strongisnt really bothered by itPe;Big boisterous dogwill let me look but doesnt like to be restrainedsmall bleeding scab on dorsal surface of neckhard to say whether lump or some type of woundwont let us do much else with himWill trial with chlorhex washesIf cant do will dispense short course of antibiotics.