C09977325 / invoice 10000

Appointment Reason: Arthritis treatment, Appointment Notes: jhHISTORY- Noticed changes in behaviour and appetite yesterday- One of her teats appears manky and irritated, noticed yesterday- Presence of a mobile, bubble-like lump on skin, noticed a couple of weeks ago, suspected lipoma- History of arthritis, in for routine arthritis injection- Previous concerns about a nipple, which was larger than others- Recent beach visit possibly aggravated the condition- Blood tests and urine analysis conducted last visit, results were normalEXAMBAREither skin tag or nipple on ventrum, seems enalrged and inflamed, about 4cm by 2cm.FNAs takenLump on R dorsum feels like lipoma- would need testing to confirmDIAGNOSIS- Suspected inflamed or infected mammary gland- Possible lipoma on skinPLAN- Apply antibiotic and steroid cream BID for the inflamed teat- Keep the area clean- Monitor the lump for any changes in size or discomfort- Take samples from the teat for further analysis, send to lab- Continue with routine arthritis injections- Recheck and further action depending on lab results    Vital Signs    Weight: 26.6;       

Samples taken, can only really inflammatory cells, RBCs, neutrophils and cocci.Called Arlen to discuss, not much value to sending off as just inflammatory response.Will allow to settle with neocort and review in a couple of weeks or at next synovan    Vital Signs