C09992736 / invoice 10000

Reason:  
History: 
Found a lump on the side of her rib. Owner thinks it feels inside/deeper. Doesn't feel like on the skin. 
First noted 2 days ago. No change in size in last 2 days, patient doesn't appear bothered with lump, did move away from owner initially. 

EDUF normal, no V+/D+
Walking is slower, limping on front paws now too

Current medications: carprofen 50mg SID, fish oil SID

Examine: 
Mentation: BAR
Body condition score: 6/9
MM:      PM          CRT: <2s
HR:    120            RR: panting
LN: wnl
Temperature: ne due to fear free handling

Ocular: nad
Oral/Dental stage: grade 0-1
Ears: nad
Cardiovascular: no murmur
Respiratory: normal lung sounds
Gastrointestinal: soft and comfortable
Integumentary & lumps (measurement, location): 3cm soft mobile ovaloid SC mass right flank
Musculoskeletal: stiff gait, painful on shoulder caudal extension bilaterally, known OA in HLs so not manipulated
Urogenital: nad
Neurological: nad

Assessment: 
1. Lump right flank
- recc cytology, owner consented, call with results
- grossly the samples appear greasy

2. OA
- progression of disease
- has trial pentosan injection previously but owner reports not much different
- discussed adding in paracetamol, beransa, consider gabapentin 30mg BID, low dose SC ketamine injections 
- owner elected to trial beransa today
- label instructions for panadol provided to owner

Treatment: 
Samples taken from right flank mass

Beransa 15mg | Batch: 813176 | Exp: 08/2026

Plan: 
Call with cytology results, plan pending results
Script on file for carprofen and beransa.

On-going medications required: Y/N (use prescription tab for further supply): Y

Cytology result:
- lots of lipid droplets, occ adipocyte
- consistent with lipoma
- advised to monitor for now, can consider surgical excision
- advised expect slow growth. If rapid or causing pain then revisit for reassessment +/- surgery

Owner happy with plan