C09982996 / invoice 10000

Reason: Lump On Leg Front And NailsAppointment Notes: esf 2/3 - 2cm with scab and some blood. will bring insurance details with herCame in with owners; AbbiH:Noticed lump a few days ago. No changes sinceUnsure how long it could have been there before thatLicking at it a bitOtherwise doing well at homeWould like nails clipped. Owner recommended muzzlin for thisPE:Muzzled out the backClipped over lesion as much as would allowDiffuse Area of thickened skin on cranial aspect of RFL above the carpusLooks less like a mass. More like infected skin /drained abscessA:- Cant rule out foreign body but cant find indication of it today- Could try and FNA but not looking like a cellular mass. Owner happy to begin with medical management. If does not resolve, FNA. May need surgical exploration.P:- Amoxyclav 750mg PO BID 5 days- Loxicom 3ml PO SID with food 3 days- Clean with dilute iodone (1:10 with water) BID for 5 days- Return if not improving over time.    Vital Signs    Weight: 45;       

    Vital Signs    

Reason: Still No Better  - PHONE CONSULTAppointment Notes: Overdue reminders mlp 14/4History: O elected not to feed last night. Settled after a few hours and stopped panting. Went to bed at 12:30am. At 5:30am pacing and panting +++. Whimpered a few times throughout the morning. Was keen for breakfast this morning - 2 handfuls of wet food - ate +++ and no more vomiting. Around 8am stopped panting excessively. Seems a bit quiet since then but has done a perfect poo  at 12pm. Not straining to urinate. Seems really quite settled. Abbi trying to decide if to bring down or now. Discussed that given is eating ok, no vomiting and passing normal stools, probably ok to pause for the moment and see how she is doing. Prevomax will wear off around 6pm tonight - Abbi has zofran at home so if vomiting recurs after hours, can give zofran to tide over until can see dog tomorrow. O happy with this plan. Plan: Monitor overnight. Keep an eye on vomiting, appetite, faeces. Can use zofran 8mg - 2x wafer BID tonight if nausea/vomiting recurs as prevomax wears off - O has some at home. Recheck tomorrow if deteriorates again tonight with view for bloods/imaging    Vital Signs