C10031824 / invoice 10000

Reason: Sore pawAppointment Notes: Paws App Details:History:  Skin improving. Earlier in the week seemed to have a lameness on a hind leg. Resolved.No lameness on forelimb, improved today.Is very playfulExamine:  BAR. Slightly shorter stride on left fore.Palpation of both forelimbs - joints wnl.  No effusion, no heat.Long bone palp wnl. No pain detected.Shoulder, elbow and carpus range of motion wnl.Paws wnl.Assessment:  no pain localised. Could be soft tissue injuryTreatment:  Rest. Monitor for shifting lameness or swellings.If painful ongoing or sees intermittent signs then do est for GA and xray forelimbs looking for panoestitis/HOD.    Vital Signs    Weight: 28.7;       BodyScore: 5/9;       

Appointment Notes: lchHistory:  skin is improving. Some partial alopecia. Mild pruritus.On advance dry and bone broth/probiotic.On nexguardTwo testesNo herniaNo murmurCutting teethPink mms refil 1 sec normal occlusionNormal stoolsEeno nadProtech c3.To be sterilised.    Vital Signs    Weight: 22.7;       BodyScore: 3/5;       

Reason: Itchy SkinAppointment Notes: Paws App Details:Booking Type: Skin ConsultationBooking Notes: Itchy Skin Owner Name: Mrs Crystal FinchOwner Email: crystalfinch66@gmail.comOwner Mobile Number: 0400476765Pet Name: TexPet Species: DogPet Insured: NoWeb BookingClient name: FinchContact number: 0400476765Email address: crystalfinch66@gmail.comPatient name: TexHistory: Happened on his chestNot red just scabby. Had this problem before when first acquired. - owner was putting shirts on to prevent him from scratching all the time. Healed pretty quickly within 1wk of doing it. Sunflower oil was the only thing to stop him from itching back then. Now same thing happen again, but it's everywhere now on the skin. Itching wasn't constant. - wouldn't stop to itch, mainly itch when he's resting. Examine: BAR, vitals wnl; no enlarged lymph nodes palpable. Auscultation wnl. Diffuse pustular/ crusty dermatitis almost entire ventrum, but certainly most severe over chest/ pectoral muscle extending dorsally up lateral chest/ axillary regions. Skin not overly erythemic apart from axillary area. Lesions appear pruritic- with gental palpation dog wants to itch. Ears & paws appear wnl. Laboratory: impression smear obtained from exudates under the crusts - neutrophilic inflammation, some bacteria; no yeast i could appreciate. Assessment: presentation seems to suggest contact allergy? evidence of secondary bacterial infection- i feel that once infection controlled, pruritus should subside quickly, hence no antipruritic dispensed. If owner feels that the improvement is not sufficient, can come back for once off cytopoint inj with nurse. Treatment: cephalexin 500mg (= 29mg/kg) po bid x 14 days Pyohex shampoo twice weekly then taper in accordance with clinical improvement Pyohex conditioner daily Plan: if owner wishes, can come in to do a once-off cytopoint inj with nurse at 1mg/kg. Otherwise, reassess skin when back in for final vacc.    Vital Signs    Weight: 17;       MMColour: pink ;       Temperature: 38.7;       HeartRate: 156;       BodyScore: 4/9;       DentalGrade: - ;       CRT: <2 ;