C09985551 / invoice 10000

Reason: Cranial Mediastinal MassHistory summary:*Aggressive*Darcy is a 10yo MN Jack Russel Terrier, who presented for a possible cranial mediastinal mass. Darcy initially presented for a dry cough that started three days prior to presentation. One cough produced thick opaque yellow/white phlegm. A grade 4/6 heart murmur was noted and did not cough on tracheal pinch, and a doxycycline trial was commenced to rule out upper respiratory tract infections. A slight improvement was noticed after a course of doxycycline. Owners noticed that the coughing occurred mostly when excited and a second productive cough was noticed. Owners also reported that there was possible syncopal events. Thoracic radiographs were performed, which showed an enlarged heart and a poorly defined cardiac silohouette. An echocardiogram showed stage B2-stage C MMVD with severe atrial distension. Darcy was started on pimobendan and furosemide. A CT of the chest showed a large cranial mediastinal mass that was well-defined and moderately contrast-enhancing. Mild splenomegaly and hepatomegaly, with mild quadrate lobe heterogeneity, as well as multiple choleliths were seen on Ct. A TT4 was run, which was markedly elevated at 89 (13-47).Initial ConsultationRecord is In/CompleteRDH/LPPresenting problem:>State reason for the presentation or referral here<Referred by: (name of vet and/or clinic)History:Concurrent or previous pertinent disease:Age obtained:        2?                      Place obtained from: rescueVaccination: C5 (feb 26)Parasite prophylaxis: Nextgaurd chew (feb 26)Environment:  indoorExercise tolerance: 1x 20 minute walk every dayTravel history:  noneOther pets: NoneCurrent diet: Hils I/D dry and wet food + rice + rcotta am and pmCurrent medication: Pimobendan 0.2mg/kg PO BID, last given this morningRecent pertinent diets or medications usedFurosemide course finished on tuesdayRecent laboratory results:Recent imaging results:Other owner concerns:Some GI upset on and off, has improved with I/D dietPhysical Exam: Demeanour:    Hydration:Eyes: Funduscopic examination:Nose:       Ears:        Oral:Lymph nodes:Thyroid:Circulation: (cardiac auscultation, pulse)Respiration: (pattern, auscultation)Abdominal palpation:Rectal examination:External genitalia:Skin:Musculoskeletal: MCS:Neurological: Current Problems:Plan:Diagnostic:Therapeutic:Follow up:Assessment:Client Communication:    Vital Signs    Weight: 7.9;       MMColour: pink;       Temperature: 38.9;       HeartRate: 120;       BodyScore: 4/9;       RespirationRate: pant;