C09996426 / invoice 10000

Subjective:Tank is presenting for a vaccine booster. He has been reported to be scratching lately, which may be related to fleas from contact with other dogs. He receives Next Gen for parasite control and a white dewormer for tapeworms. He gets bathed when visiting other locations. Tank previously had a lump reaction to a vaccine which has since resolved. Tank has insurance through Trupanion.Objective:Temperature: Normal on examHeart Rate: Normal on examWeight: 15.1 kgRespiratory Rate: Normal on examCapillary Refill Time: Normal on examMucous Membranes: Normal on examHydration Status: Normal on examBody Condition Score: Normal on examPain Score: Normal on examFear Anxiety Stress Score: Normal on examEyes: Normal on examEars: Slight redness noted, some debris present in ear canalNasal: Normal on examOral/Dental: Normal on examCardiovascular: Normal on examRespiratory: Normal on examNeurological: Normal on examMusculoskeletal: Normal on examLymphatic: Normal on examGastrointestinal: Normal on examReproductive/Urinary: Normal on examIntegument: Redness noted on muzzleMasses: Previous vaccine reaction lump has resolvedAssessment:- Generally healthy- Mild ear debris present- History of vaccine reaction (hard lump swelling 1 weeks post first vaccine)- Some skin irritation presentPlan:- Administered vaccine booster- Recommended cleaning ears with cotton buds and ear cleaner- Monitor for vaccine reaction similar to previous occurrence. Unlikely will need vet visit if appear similar to last time.- Continue current parasite prevention- Next vaccine due in one year

Presenting for lump on dorsal cervical region, SC, acutely presentedVaxed 18/7 - most likely in area of concernDiagnostics:- FNA of lump- Cytology assessed under microscope -inflammatory cells (neutrophils), no bacteriaPlan- Monitor size of lump, based on cytology expect regression of size and most likely inflammatory granuloma from vaccine reaction - INI revisit for further diagnostics

Subjective:Tank is a 1 year 8 month old French Bulldog presenting for a medication review for Cytopoint. There is concern about a mass on one of his front feet that appeared after dropping a bowling pin on it. The mass was reportedly twice the size initially but has decreased significantly. Tank is currently on a diet of dry food and roast chicken with rice (no bones). He receives regular baths, at least once weekly, sometimes twice weekly with Malaseb shampoo or medical alternatives. Tank's last Cytopoint injection was on May 23rd, approximately two months ago. No current itching reported.Objective:Temperature: Normal on examHeart Rate: Normal on examWeight: Just under 15 (units not specified)Respiratory Rate: Normal on examCapillary Refill Time: Normal on examMucous Membranes: Normal on examHydration Status: Normal on examBody Condition Score: Normal on examPain Score: Normal on examFear Anxiety Stress Score: Normal on examEyes: Normal on examEars: Normal on examNasal: Normal on examOral/Dental: Normal on examCardiovascular: Normal on examRespiratory: Normal on examNeurological: Normal on examMusculoskeletal: Normal on examLymphatic: Normal on examGastrointestinal: Normal on examReproductive/Urinary: Normal on examIntegument: Normal on examMasses: Mass on front foot, significantly decreased in size from initial presentationAssessment:- Overall healthy condition- Mass on foot likely traumatic in origin, improving- Due for vaccination booster (last vaccination February previous year)- Currently no signs of skin issues or pruritusPlan:- Monitor foot mass, recheck at next visit- Owner to continue monitoring for itching, can book nurse consult for Cytopoint when needed- Vaccination booster recommended and scheduled- Continue current bathing routine- Consider using Otoflush if ears become gunky- Owner advised to clip fur around any future masses for better visualization during examination