C10027745 / invoice 10000

Reason:Presented for whining, tachypnoea and shivering. Treatment:1. Tachypnoea, shivering, whining (behavioural changes)2. Mammary gland enlargement and lactation3. Nesting behaviour4. History of recent oestrus (8 months prior) Gabapentin 300mg capsules prescribed.Dx:Respiratory signs (panting) are considered behavioural/stress-related rather than due to a primary respiratory issue, supported by a normal SpO2.The current primary diagnosis is pseudopregnancy. Follow up call:

Presented for skin irritation. For the last 2-3 months has been really itchy. Has been chewing at feet, licking at abdomen, backs of legs, underside of chin. No issues in past. No medications. No shampoos. No new plants - does rub belly on grass. Did not recognise any plants from handout. Mammary chain is thickened in R-area; does get pseudopregnancies often and last heat was 2m prior. New skin tag on nipple.Diet - coles brand; changed to skin diet r/c yesterdayPE:  Cardio: Regular rate and rhythm, no murmur detected.  Resp: No wheezes or crackles auscultated Oral: CRT <2s, pink and moist MM. Eyes: Bilaterally symmetrical,  clear and no presence of discharge Ears: No erythema or discharge noted Integument: Pinpoint scabbing and erythema over abdomen and medial surfaces of legs. Marked brown fur discolouration over all 4 paws. Marked oedema/erythema of ventral pawpads. Marked erythema and chronic thickening of skin adjacent to lip folds on the ventral surface. L-mammary gland nipple has a pendunculated pink skin mass.Genitourinary: R-side mammary chain 2x size of L-mammary chain - no overt nodules or growths, generalised thickening of entire caudal chain. No heat or discharge noted. Assessment      Ddx:Contact allergies > vs environmental vs atopy vs parasitic > food allergiesDiscussed treatment options with owner. Can treat current flareup but recommend ongoing allergy management to prevent recurrence of signs (Apoquel vs cytopoint). Owner does not wish to to this yet; happy to return with nurses for cytopoint within next few months. Would prefer topical management, is aware of limitations. Gave plant handout for owner to assess environment for presence. Treatment Pred 20mg SID 6dMalaseb 2x weekly ongoing Cortavance SID no more than 7d, 1-2x weekly for maintenanceConsider cytopoint for ongoing management

Doing much better and toe no longer sore. Got D+ when on meloxicam and O felt was more flat. No change to lumps at home so O will continue to monitor for now and call back if getting bigger.