C10031701 / invoice 10000

Reason: Excessive Licking Of Bottom CCKGM Appointment Notes: EDDU fine no discharge  ------- Sms reply: YHistory:Presenting complaint is persistent licking of bottom and paws. The owner reports this has been occurring for a while. The licking primarily occurs during periods of rest, such as when lying on the floor. It affects his paws and "a bit everywhere". The licking is not severe enough to interrupt playing or eating. EDDU normal. No V+ or D+.Previous treatment from this clinic for paws involved a medicated shampoo (malaseb), which the owner reports was ineffective.Current meds: nilVaccination: UTD. Next due end of August.Parasite Prevention: Nexgard SpectraExamination:Mentation: BARMm: pink, moistCrt: <2secHydration status (%): hydration clinically adequateEyes: NSFLymph Nodes: NSFGastrointestinal:Oral: normal, no mouth pain, dental score (1-4): 1Abdominal: no detectable pain or pathology on abdominal palpationRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painIntegument/Ears: Erythema noted on the skin around the perineal area. Interdigital skin appears inflamed all four paws consistent with licking. Ears, ventrum, and axillae are normal. Coat is in good condition but quite long. Anal glands checked, no concerns.Body Condition Score: 6/9Genitourinary: NSFTemp: not attemptedLaboratory:NoneAssessment:Problem list:1. Pruritus, perianal dermatitis, pododermatitis: working dx atopic dermatitis, possibly secondary yeast or bacterial infection.Treatment:Zenrelia SID 14 daysUse Malaseb shampoo twice a week for two weeks on affected areas (paws, perianal region).Plan:Continue Zenrelia for the full two weeks, even if clinical signs resolve sooner.Re-evaluation if pruritus recurs after cessation of medication. The medication is safe for long-term or intermittent use as needed for flare-ups.Weight management recommended. Target weight is 13.0 to 13.5 kilograms. Aim for gradual weight loss.Consider adding a good quality omega-3 supplement to food to help strengthen the skin barrier.Home into owner's care.Client communication:Discussed the likely diagnosis of atopic dermatitis, commonly worse in the wet season, and the role of secondary infections. Explained that allergy testing is possible but treatment is focused on controlling inflammation and itch regardless of the specific allergen.Advised to continue medication for the full course. Instructed on the use of medicated shampoo for paws and perianal area. Discussed that Zenrelia is a safe medication for future flare-ups and to contact the clinic if more is needed.Discussed weight gain of one kilogram. Advised on a target weight of 13.0-13.5 kilograms and the importance of gradual weight loss.Recommended an omega-3 supplement to support skin health.    Vital Signs    Weight: 14.4;