C10029741 / invoice 10000

Species:CANINE
Breed:Cavalier King Charles Spaniel
Age (years):2
Diagnosis or signs:. Chronic Generalised Dermatitis & Otitis
Consult notes
Reason: Skin & Ears

History:
- Ongoing itching - around lips, ears, elbows, knees, belly, sometimes dragging bottom as well
- O applied pseudocrem last night and thinks it has helped settle itching
- Has previously responded well to steroids and antibiotics, but itching recurs soon afterward
- O has tried Scratch kangaroo diet to no avail
- Otherwise well, EDUF normal

Past Medical History:
- No current medications
- Nexgard Spectra UTD
- De-sexed
- Diet: Constantly changing - very fussy eater - roast chicken + kibble
- Using Rufus & Coco oatmeal shampoo, not bathed too frequently

Examination: BAR, very well-behaved, loves treats
BCS 6/9
MM pink & moist
Eyes NAD
Ears - moderate erythemic bilaterally (R>>L), pseudocrem evident on pinnae, no excessive discharge noted
Nose NAD
Oral/Dental 1/4
Chest auscult NAD
Abdo palp NAD
LNs WNL
T NE
Integ - moderate erythema of paws, mild papules around stifles

Laboratory: NIL

Assessment:
1. Chronic Generalised Dermatitis & Otitis
- Lengthy discussion regarding etiology (food vs environmental), secondary infections.
- Discussed options for referral & desensitisation vs Cytopoint/Apoquel trial - gave brochures.

Treatment:
- Cytopoint 20mg SC
- Cephalexin 200mg PO BID 14d
- Mediderm shampoo weekly on affected areas until skin settles

Plan: Re-check INI in 3-5d.

Animal clinical history (3 most recent)

2026-03-12T00:00:00Z 16:40:00
Reason: Skin & Ears

History:
- Ongoing itching - around lips, ears, elbows, knees, belly, sometimes dragging bottom as well
- O applied pseudocrem last night and thinks it has helped settle itching
- Has previously responded well to steroids and antibiotics, but itching recurs soon afterward
- O has tried Scratch kangaroo diet to no avail
- Otherwise well, EDUF normal

Past Medical History:
- No current medications
- Nexgard Spectra UTD
- De-sexed
- Diet: Constantly changing - very fussy eater - roast chicken + kibble
- Using Rufus & Coco oatmeal shampoo, not bathed too frequently

Examination: BAR, very well-behaved, loves treats
BCS 6/9
MM pink & moist
Eyes NAD
Ears - moderate erythemic bilaterally (R>>L), pseudocrem evident on pinnae, no excessive discharge noted
Nose NAD
Oral/Dental 1/4
Chest auscult NAD
Abdo palp NAD
LNs WNL
T NE
Integ - moderate erythema of paws, mild papules around stifles

Laboratory: NIL

Assessment:
1. Chronic Generalised Dermatitis & Otitis
- Lengthy discussion regarding etiology (food vs environmental), secondary infections.
- Discussed options for referral & desensitisation vs Cytopoint/Apoquel trial - gave brochures.

Treatment:
- Cytopoint 20mg SC
- Cephalexin 200mg PO BID 14d
- Mediderm shampoo weekly on affected areas until skin settles

Plan: Re-check INI in 3-5d.

Previous claim history (2)

DateClaim #Diagnosis
2025-03-10C8432178EAR INFECTION
2024-12-13C8074309BLEPHAROSPASM

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_consultation96.002026-03-12
20000tstarc_skin_medication_-_cytopoint202.402026-03-12
30000tstarc_antibiotics_-_cephalexin56.052026-03-12
40000tstarc_medicated_shampoo28.802026-03-12

UPM+

  • DG00592DERMATITISDSTP_skin_-_dermatitis

Variant (sleepy_king)

HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.570
Threshold: 0.38
Above:
Correct?
Reason (correct)