C09986374 / invoice 10000

Appointment Notes: possible g/s in pawSubjective: OR licking RF paw excessively, not licking any other paws No lameness observed Otherwise DUDE as normal no V+/D+ OR lump on flank wanting checked Objective: BARHR/PR/CV: HR 108, No murmur, pulses SSMM/CRT/Hydration: MMs PM, CRT <2sRESP/RR: Chest ausc. clear, no crackles / wheezing Temp: NT GIT/UG:  Abdominal palpation comfortable and unremarkableSkin/Ears: Coat & ears clear, generalised moderate interdigital erythema all 4 paws > RFL interdigital skin mild ulceration ~0.3cm in diameter just caudal to D5 paw pad, generalised interdigital cutaneous erythema > Fixed s/c firm mass R dorsum ~2cmx1cm in sizeM/S: Ambulating well around consult, NAD on digit & joint palpation bilateral FLs, full ROM achieved comfortably Eyes: bright and clear, no ocular discharge Dental: Gr 1/4Lymph Nodes: PLNs WNL BCS: 6/9Laboratory: FNA mass: > Thick pale-yellow material aspirated > Amorphous proteinaceous material Assessment: 1. Licking RF paw ddx: related to small interdigital ulceration vs allergic dermatitis vs FB vs other 2. Mass R flank ddx: benign vs malignant Treatment: Meloxicam 1mg PO SID Discussion with Owner: Advised nothing clear to indicate GS today. Otherwise no cellular material evident on cytology, most suspicious of sebaceous gland material due to appearance and consistency of material & cytology. Advised to monitor. Plan: > INI in licking of RF paw consider apoquel vs CT of limb > Monitor mass R dorsum, if causing irritation vs increasing in size markedly consider excisional biopsy> FUC in 3d    Vital Signs    Weight: 12;