C10031467 / invoice 10000

Reason: Skin Issue: Red "Rash" 15cm On Rear Leg Near AnkleAppointment Notes: -LRHistory:Presenting for: French Bulldog presented for skin issues and itchingHistorical Conditions:- Brachycephalic breed with associated breathing issues- Recently been in season(came off about 5 days ago)  Skin:- Current itching and skin rash down the front of her back legs - some nipple rednessExamination:Mentation: BARWt: 11.2 kgNose: Short nose even cf the O other Frenchie and quite a bit of upper respiratory noise. Nares aren't particularly small so assuming mostly backof throat issues.Great teethEyes and ears NADMusculoskeletal:- Very short cranial to caudal esp thorax - very suspicious she will have vertebral malformationss- left stifle grade patella 1 luxation. Could not move right out of groove today.Urogenital: Recently finished oestrus cycleAssessment:Pruritus and dermatitis - likely allergic in nature given breed predispositionBrachycephalic obstructive airway syndrome - BOA surgery candidateLuxating patella - mild gradePost-oestrus with increased infection riskPlan:New Meds/Tx:- Cytopoint injection administered  right flank 840616- Neocort topical cream dispensed for rashes (not for cuts)- Medicated shampoo wash if needed, available over the counterAdditional Discussion:- JAK inhibitors and corticosteroids avoided due to recent oestrus and infection risk- Soft palate surgery recommended - referral to specialist required as not performed in-house- Nostril surgery can be performed in-house but soft palate requires specialistClient Comms:- Monitor skin condition - should improve with current treatment plan- Consider desexing to reduce future infection risk and enable other treatments- Discuss specialist referral options for brachycephalic surgery. Hopefully can have the desexing at the same time.    Vital Signs    Weight: 11.2;       Temperature: 39;       HeartRate: 120;