C09977694 / invoice 10000

Lump has come up again

Hx: 
Groomed the other day, now noticed a few little lumps. Dog only seems bothered by the one on its leg, but also has one of its dorsal trunk.
EDDU ok
No hx v/d/c/s
Diet: kibble 
Not on any current medications or supplements
Walked regularly
Parasite preventatives UTD 
Owner has no other health concerns 

Exam: BAR
Vitals WNL
EENT: NAD; dental disease 0/4, cornea/sclera clear OU; mm pink/moist
Cardio: NAD; no heart murmur/arrhythmia, CRT <2sec, HR=PR
Resp: normal rhythm, clear bronchovesicular sounds, RE 0/3
LN: NAD on palpation
Integument: 
- Mass 1: small round focal mass in the subcut approx 5mm in diameter, no ertyehma, no alopica, no crusting. Located on the RHS of the dorsal thorax 
- Mass 2: small round focal mass on the RHL near hock approx 2mm raised, some crusting, no alopecia. 
- Smooth coat 
Abdo palp: NAD; comfortable, no pain elicited, no organomegaly/mass palpable  
Urogenital: NAD; no discharge detected, bladder soft and comfortable 
Musculoskeletal: NAD. ambulatory x4, appropriate gait
Neurological: NAD, appropriate mentation

Assessment: 
Mass 1: FNA purulent discharge with few neutrophils, some adipocytes. Dd infected hair cyst
Mass 2: ruptured hair follicle

Treatment:
Amoxyclav 500mg PO BID for 7 days - may not get resolution, can do surgery to remove. 
INI reassess 

Vacc

Hx: 
Going well at home, EDDU ok
No hx v/d/c/s
Diet: kibble 
Not on any current medications or supplements
Parasite preventatives UTD - nexgard spectra 
Owner has no health concerns 

Exam: BAR
Vitals WNL
EENT: NAD; dental disease 0/4, cornea/sclera clear OU; mm pink/moist
Cardio: NAD; no heart murmur/arrhythmia, CRT <2sec, HR=PR
Resp: normal rhythm, clear bronchovesicular sounds, RE 0/3
LN: NAD on palpation
Integument: NAD; smooth coat 
Abdo palp: NAD; comfortable, no pain elicited, no organomegaly/mass palpable  
Urogenital: NAD; no discharge detected, bladder soft and comfortable 
Musculoskeletal: NAD. ambulatory x4, appropriate gait
Neurological: NAD, appropriate mentation

Assessment: 
Fit for vacc

Treatment:
Protech C3 + C2i SC - repeat in 1 year
Canigen KC SC - repeat in 1 year
Continue nexgard spectra monthly  

Lump on noeck

Hx: 
Noticed a small lump on the back of the neck, unsure how long it has been there for. Doesnt seem to be affecting the dog. Not overly tchy unless owner touches it. 
No surrounding redness or discharge. 
Owner tried to clip it. 
Going well at home, EDDU ok
No hx v/c/s - sometimes gets poopy 
Not on any current medications or supplements
Walked regularly
Parasite preventatives UTD 
Owner has no health concerns 

Exam: BAR
Vitals WNL
EENT: NAD; dental disease 0/4, cornea/sclera clear OU; mm pink/moist
Cardio: NAD; no heart murmur/arrhythmia, CRT <2sec, HR=PR
Resp: normal rhythm, clear bronchovesicular sounds, RE 0/3
LN: NAD on palpation
Integument: NAD; smooth coat 
Abdo palp: NAD; comfortable, no pain elicited, no organomegaly/mass palpable  
Urogenital: NAD; no discharge detected, bladder soft and comfortable 
Musculoskeletal: NAD. ambulatory x4, appropriate gait
Neurological: NAD, appropriate mentation

Assessment: 
Mass - large scab, healing wound on back of neck, like dog ran uder something and got scratched. Healthy tissue present. 

Treatment:
Area clipped and cleaned. 
Neocort applied. 

Plan:
Cephalexin 600mg PO BID for 5 days 
Neorcort BID 
Keep clean
INI reassess