Discharge summary
Summary of Xena's visit on 07/28/2025
Doctor: Jennifer Rubinstein, DVM
Tech: Urgent Care Renton
Client
Dan Wheeler
(206) 387-7127
dan@quizkid.net
Patient
Xena
6 years
Intact female
Discharge notes
Presenting Complaint: Xena, a 6 years Intact Female German Shepherd Dog, presented to BoosterPet Urgent Care on 07/28/2025 for some blood, maybe infection in genital area. Large wart/calouses.
Physical Exam:
General appearance: BAR
EENT: No ocular or nasal discharge
Lymphatic: No peripheral lymphadenopathy
Integumentary: Healthy coat. Flea comb found flea dirt, possibly one live flea. Callouses on both hocks with scabbing. Perineum is inflamed with fecal debris. Hair around vulva is discolored
Cardiovascular: No murmurs/arrhythmias, pulses strong, synchronous, mm pk/moist, CRT< 2 sec
Respiratory: Eupneic; lungs clear
Gastrointestinal: Abdomen soft, non-painful on palpation.
Urogenital: External genitalia within normal limits
Musculoskeletal: BCS 5/9, ambulatory x4 with no obvious lameness or weakness
Neurologic: Mentally appropriate, no obvious neurologic deficits.
Plan - recommended flea/tick/HW preventative, clean rectal and area around vulva. Owner has cone and gabapentin at home.
Diagnostics:
- 4Dx Snap test: Negative
Treatments:
- Cleaned perineum/vulvar area. There was some suspected dried blood below her vulva which is suspected to be due to a heat cycle.
Problem list:
Licking at vulva/perineum: may be due to fleas vs. allergies vs. other
Scabs on hocks: these are callouses due to pressure most likely. The scabbing may be due to where she is laying or she is affected by the fleas and chewing/licking them.
Medications prescribed:
See below
Gabapentin: Give 300-400mg every 8-12 hours by mouth for next 5-7 days or until signs stop. Owner has at home. Analgesic. May cause sedation.
Case summary:
Xena was seen today for excessive licking in her perineal/vulvar region. We did find fleas around her tail base. There was discoloration, inflammation around the areas along with some fecal material around her rectum and underneath her tail. All areas were gently cleaned.
We will treat her for fleas and get the areas cleaned-up. She can start the antibiotic and gabapentin. She will need to wear a cone at all times for at least 7 days.
Home Care:
Please clean all areas where she spends time - including floors, furniture and bedding.
Due to the changes in our region, we do recommend continuing the flea/tick/heartworm preventative year-round. She will need a heartworm test annually.
If she misses more than one dose of her preventative, a repeat test is required.
If her condition recurs or worsens, please have her rechecked.
Due to her anxiety/excitement, you may want to give gabapentin 2 hours prior to her next visit.
Thanks for bringing Xena in today. We hope she feels better soon.
We have treated your pet through our BoosterPet Urgent Care service at this time, but we are not a replacement as your pet's primary care provider. Please plan to return to your primary care veterinarian or establish care with a primary care veterinarian for any further follow-up care, unless otherwise specified (i.e. going to a 24/7 ER hospital due to more critical condition).
Prescribed
Simparica TRIO | 72.0 mg Chew Oral Brown Canine 88.1 - 132.0 lbs
Dispense: 6 Chew(s)
Instructions
Administration notes: Give 1 chewable tablet by mouth every 30 days for flea/tick/heartworm prevention. Give with food.
Cephalexin | 500 mg, Capsule, Oral
Dispense: 28 Capsule(s) | Drug expiration: 07/28/26
Instructions
Administration notes: Give 2 capsules by mouth every 12 hours for 7 days. Give with food. Antibiotic.
MiconaHex+Triz | Wipe Topical
Dispense: 1 Bottle | Drug expiration: 07/28/26
Instructions
Administration notes: Apply to affected skin around rectum and vulva 1-2 times daily. Antifungal, antiseptic medication,
Details from Xena's visit
Plan
Medical notes
Presenting Complaint: Xena, a 6 years old Intact Female German Shepherd Dog, presented to BoosterPet Urgent Care on 07/28/2025 for licking at her inguinal area.
History:
The owner reports that Xena has been licking excessively at her genital area and consequent bleeding. The symptoms were noticed about a week ago. Stressors include her other siblings passing, but no others noted. The owner also has concerns about hyperplasia/callouses in her hind legs, which Xena has been biting at. No known history of allergies. Normal urination and defecation.
C/S/V/D: -/-/-/-
E/D/U/D: +/+/+/+
Previous Medical History: Had similar bacterial infection ~5 years ago
Current Medications/Supplements: None
Diet: Purina One and Blue Mountain
Travel History: None
Vaccine Status: UTD
CPR/DNR: DNR
pDVM: Clover Vet Hospital
Urgent Care Renton/Jennifer Rubinstein, DVM
If your pet had a blood draw today, a small bandage has likely been placed. Please remove this bandage within an hour of your discharge.
The vet drained Xena's anal sacs.