C09980361 / invoice 10000

Appointment Reason: Coughing / Lump, Appointment Notes: Paws App Details:Booking Type: Consultation ExtendedBooking Vet: Dr OliviaBooking Notes: Lump under front leg and small lump on back & Coughing   ------- Sms reply: YO is concerned about a lump on back (L mid-dorsum). Also wanted the lump in R axilla checked. O reports cough is still intermittent but it seems to occur only after she has been licking her bottom. No cough observed today in consult. No spontaneous coughing outside of this context.O has been using In-betweener's by Dr Chris for anal glands and it seems to have worked. Hasn't scooted since starting the supplement.CE: eyes clearears cleanoral exam: pink mm, crt <1s; dental gd 1-2/4tracheal pinch: negativechest ausc: strong heart rate and rhythm; no murmurs; lung fields clear bilaterally, no wheezes or ralesabd palp: soft, pliable, non-painfulLarge soft lump R axilla - feels like lipoma, approx egg-size - had lipoma removed from this site in october 2023. O reports that it isn't interfering with gaitLump L mid-dorsum: approx 1.5-2cm, firm, not attached to underlying tissueFNA: R axilla  - lipomaL mid-dorsum: yellow fluid aspirated; vacuolated cells observed with additional cell population not definitively characterised. Cytology inconclusive.Assessment: lipoma R axillalump L mid-dorsal flank - inconclusive; possibly cysticPlan: Colleague review of cytology from left dorsal mass. If still inconclusive, submit sample to IDEXX for laboratory cytology.Thoracic radiographs recommended given age and history of intermittent cough. Owner to consider.Regarding cough: Thoracic radiographs recommended given age and historical intermittent cough. Owner to consider.    Vital Signs    Weight: 6.81;