C09978724 / invoice 10000

Appointment Notes: Lump on foot. CW?????HISTORY: 5-day history of a rapidly growing, ulcerated and pruritic lump on the dorsal right metatarsus. The patient is constantly licking the area. CURRENT MEDICATIONS: NonePREEXISTING CONDITIONS:NoneCURRENT DIET: Not discussedPE:- T-Not taken- HR Normal sinus rhythm, no murmur detected.- RR/lungs: Normal lung sounds, no increased effort.- MM-Nsf- LNN- Mild right popliteal lymphadenomegaly. Other peripheral lymph nodes normal.- ABD- No abnormalities detected.- BCS 4/9- Otoscopy/ears:- Oral health: Excellent, no calculus.- Eyes:Nsf- Msk system: Nsf- Integument: 1.5 cm raised, erythematous, ulcerated lesion on the dorsal right metatarsus with a oozing a mild purulent discharge from multiple sites. Lesion appears sl painful.Tape cytology : cluster of neuts, low numbers of cocci - Urogenital: Male entire, testicles normal on palpation.- CNS: Not routinely examined.Lab: FNA cytology of right metatarsal mass: Marked pyogranulomatous inflammation with secondary bacterial infection. Cellular morphology suggestive of a histiocytoma.PROBLEM LIST:1. Right metatarsal mass.2. Pruritus directed at mass.3. Secondary bacterial infection.4. Mild right popliteal lymphadenomegaly.Dx: Histiocytoma with secondary inflammation and bacterial infection.DDx: Bacterial granuloma.Assessment: Young dog with a clinical presentation and cytology consistent with a histiocytoma. Significant secondary inflammation and infection are causing pruritus and discomfort. The regional lymph node is reactively enlarged.Rx:1. Prednisolone: 1 tablet PO SID for 2 days, then 0.5 tablet PO SID for 2 days.2. Cephalexin 600 mg: 0.75 tablet PO BID with food.PLAN:1. Commence prescribed medications.2. Monitor lesion for reduction in size and licking behaviour.3. Advised that histiocytomas typically regress spontaneously over 4-6 weeks.4. Recheck consultation in one week.5. Owner to contact clinic if pruritus does not improve in 2-3 days or if lesion deteriorates.?????    Vital Signs