C09993946 / invoice 10000

Nurse:Any concerns the owner has / presenting problem and duration: Lump on left front leg noticed yesterday afternoon. Owner noticed licking at the area. Oscar is known to be a licker. When fur parted, lump was discovered.History: Recently given bone from butcher last week. Has been digging in garden. On thyroid medication (Felimazole) - one tablet twice daily. Doing well on medication, more active. Recently vaccinated. Bloods due April.Previously presented for similar issue: NoDiet:Parasite control:Vacc history: RecentCurrent medications: Felimazole one tablet twice dailyVomiting / diarrhoea:Defecation:Urination:Eating/drinking: Eating well yesterdayExam:Mentation BAREyes - clearEars - clearNose - clearOral - DS mm pink and moist CRT<2sThyroid palpation - all palpates normalLymph nodes - all within normal limitsCardiac:Respiratory:Abdo - soft and pliableGenitourinary clearMSK - mild arthritis noted, no pain on manipulation of joints, patellas non luxatingNeuro - clearIntegument - firm lump left front leg lateral carpal area, red patch present, inflammation present, no infection on tape impression cytology, no cells obtained on fine needle aspirate (lump does not shed cells)TempBCS 3/5Assessment:1. Firm lump left front leg with inflammation - cause of licking versus licking causing lump to be determined2. Mild arthritisPlan:Topical cream with cortisone - apply to lumpLight bandage with gauze over cream - not too thick or firmPrevent licking of areaReassess in one weekIf no improvement, surgical removal and histopathology recommendedSurgical options discussed including biopsy first versus complete excisionCone required post-surgery if proceedingCost estimate provided for surgical optionBloods due April - if surgery before then, no additional bloods required; otherwise can do on day of surgeryThyroid medication timing discussed - ideally 4-6 hours after dose for surgeryRevisit require: Yes - one week to reassess lump.    Vital Signs    Weight: 31.5;