C09976178 / invoice 10000

Reason: Enlarged NippleAppointment Notes: KAHistory:Presenting for: Chanel, an intact female dog of unspecified age and breed, presented for evaluation of a swollen left cranial nipple first noted by the owner on Sunday/Monday. Concern raised due to prior history of cancer.Historical Conditions:- Histiocytoma - previously treated; surgical excision performed at SASH (approx. June 2024)- Post-operative Meloxicam reaction following SASH surgery - caution advised- Adenocarcinoma - previously diagnosed and treated at SASHSkin:- Left cranial nipple noted to be swollen since Sunday/Monday- No known trauma, bite wounds, or altercations with other dogs reported- No licking or self-trauma to the nipple noted by owner- No topical treatments applied to the area prior to presentationExamination:Mentation: BART: Not TakenIntegumentary:- Left cranial nipple: approximately 3x normal size, erythematous and inflamed at the base; appearance consistent with superficial infection/trauma rather than neoplasia per veterinarian's initial assessment; rule out histiocytoma given prior history- Patient not reactive to palpation of affected nippleAssessment:Left cranial nipple swelling and inflammation - DDx: superficial infection/traumatic injury (primary clinical impression), histiocytoma recurrencePlan:Diagnostics:- Fine needle aspirate (FNA) of left cranial nipple to be performed under local anaesthesia; cytology to be evaluated in-house under microscope prior to determining further managementNew Meds/Tx:- Local anaesthetic applied topically to left cranial nipple; 10-minute contact time required prior to FNA- Pending cytology results, treatment plan to be determined - options include topical cream and discharge home, or in-clinic monitoring/treatmentClient Comms:- Melissa (Cameron's sister) advised to return in approximately 30 minutes (by 11:00) for results and handover- Veterinarian's initial clinical impression is superficial infection/traumatic injury; however, histiocytoma must be ruled out given prior oncological history- Treatment plan to be confirmed following cytology review    Vital Signs    Weight: 11;