C10029799 / invoice 10000

Presenting problem: Presented for investigation of skin - scabs/bumps. Also due for vax
History:
Owners have noticed scabs, bumps, and some dry skin on the belly area. The issue was noticed last night.
Pruritus is present, with scratching observed around the face and neck - though not excessively, only a few times during the day. Daughter says does scratch at night too.  This is the first time these signs have been observed.
Generally well at home, walking around normally.
Eating, drinking, urinating, and defecating normally. Uses metal bowls, washed daily.
No vomiting or diarrhoea reported
O had seen a possible flea - saw something but it disappeared in the fur - sounds like likely was a flea.
Indoor/outdoor cat but has mostly been indoors lately.
Current parasite prevention: Revolution Plus was administered a few days ago, prior to that it had been 2-3 months since the last dose.
Vax - due now. Previously been a bit quieter after vax, but still EUDD normal and back to normal by next day.
Physical Examination:
BAR
Mouth: MM P&M, CRT<2s, grade 1-2 dental dz only
Small scab to RHS face
Chest NAD, HR: 128
Ventrum - papules present, and a scab noted near one nipple. No scale. 
One red sore noted to dorsum caudal thorax area.
abdo palp NAD
rest of skin looks normal
Flea comb NEG for fleas or flea dirt
Diagnostics:
A tape strip cytology sample was collected from the skin lesions. Microscopic examination revealed a significant number of inflammatory cells (neuts) and mild cocci
Assessment:
Pruritus and papular dermatitis, with evidence of bacterial infection. This infection could be primary or secondary to underlying issue such as allergy (eg FAD)
Treatment:
0.66ml cevofecin SC (difficult for oral meds).
0.4ml dexapent sc for pruritis
The annual vaccination was postponed until the skin infection has resolved.
Plan:
Continue monthly flea prevention rigorously. Owners were counselled on the importance of this for flea allergy dermatitis.
Discussed options for comprehensive parasite control, including Nexgard Spectra spot-on, which also covers tapeworm - likely will change over to this after revolution plus finishes
Recheck consultation booked in two weeks on 27/03/2026 at 5:00 PM to assess the skin and proceed with the annual vaccination if resolved. Owners advised to call if the skin condition worsens before then. If underlying allergy is the trigger, then may require longer term management.