C09980144 / invoice 10000

Reason: Lump,  HW Test + SR12, Bravecto + Worming JWAppointment Notes: has lump on neck. has been there around 2 weeks. O thought happened from dog park but unsure as to what it is. has also never been on heartworm prevention ( noticed on sat) please do test.Please go through costs with the owner and explain everything JWHistory:  Noticed a lump on left medial neck region for 2 weeks, not getting bigger and not bothering the dog otherwise doing well at home eddu normal, only UTD bravecto not UTD HW preventionExamination:  BARMM pink CRT<2Lung sound clearHR 108 RR panting temp not taken too boisterousWalking fine no limping/ataxia7mm lump on left medial neck region Tried FNA quite difficult to get as dog very boisterous, and lump too smallFna noticed cytology: RBC, some clumps of round cell, very histiocyte lookingIH heartworm antigen tes -ve, thick smear -ve microfilariaAssessment:  Lump ddx histiocytoma vs othersPlan:Proheart 1.51ml SCDiscuss about sending slide to lab eg IDEXX for cytology or lumpectomy and histology to confirm itOwner prefer just further monitor at home if histiocytoma most likely will regress in 1-2 months Close monitor if growing bigger/ulcerated etc recheck asap    Vital Signs    

History:  Examination:  Laboratory:  Assessment:  Treatment:  Plan:    Vital Signs    

    Vital Signs