C09997576 / invoice 10000

Appointment Reason: Dental procedureReason: Dental - Scale And Polish with extractions and lump removal PREANAESTHETIC EXAMINATION:HR 88  RR 36  MM pink  CRT < 2 secs Thoracic Auscultation findings:  Normal/ Abnormal  Pulse Quality: Normal and synchronousLABORATORY: Preanaesthetic bloodwork: Elevated BUN,  PCV 54%Unable to run haematology today Attempted to collect urine sample but was unable to collect CLIENT COMMUNICATION LK st Jann Advised that BUN is elevated - poss causes pre-renal (dehydration), renal or poss GI tract bleeding etc. Discussed postponing procedure today and sending bloods for SDMA and collecting urine sample. Jann would prefer to go ahead Aware on risks to kidneys Also when checking Buzz over noted scaly lump in front of right elbow.  Black in colour.  Decided to prioritise this lump over extraction of fatty lump on ventral thorax TREATMENT: Pre-medication - Medetomidine 0.05mL + Methadone 0.2ml - good sedationIV catheter placed FL and hartmans fluids started.  Gave one 5ml/kg bolus over 15 minutes prior to proceedure.  Induction - Alfaxalone IV to effect - smooth inductionIntubated with s ET tube and cuff inflatedMaintenance - iso and O2Procedure - Dental extraction, scale and polishInitially was planning on extracting 104 and 204 but repeat radiographs and probing did not reveal any pockets today just gum recession so opted to leave. 0.2ml lignocaine used as nerve block in following locations right caudal maxillary Left caudal maxillary left caudal mandibular Extraction performed of following teeth 102 - simple extraction 209 - surgical extraction - Gingival flap created, sectioned teeth and  extracted roots. Sutured gum with 5/0 monocyn 311 - simple extraction Routine scale and polishLump in front of right elbow was clipped and preppedTaken into surgery for lump removalElliptical incision and removed black mass.  Sent for histopathology. SC sutures - 3/0 monocyn Intradermal sutures in skin Skin glue POSTOPERATIVE MANAGEMENT:Smooth recovery PLAN: Avoid metacam due to elevated BUN Home on Gabapentin 100mg - give one capsule twice a day.  Can reduce to half a capsule if becomes to sedated Also advised to give half a 125mg childrens paracetamol tablet (off label) Discharge instructions emailed to client via vetcheck.  DischargeBUzz had 3 teeth extracted and a lump removed under general anaesthetic1. Please monitor closely for the next 24 hours - demeanour, appetite, eating, drinking, urination, defecation, vomiting or diarrhoea. 2. Please feed rolled up mince (soft food) for the next 7 days then slowly transition to normal food3. Please monitor the mouth for redness, swelling, discharge or pain4. Please administer the medication as prescribed- Gabapentin 100mg capsules- Give one capsule every 12 hours.  Can reduce to half a capsule every 12 hours if sedation occurs - Paracetomol 120mg tablets (children's panadol tablets) - Give half a tablet every 12 hours as needed for pain - Amoxyclav 200mg tablets - Give half a tablet twice a day for 5 days 5. Please come back in 7 days for a recheck 6. If you are concerned feel free to give us a call 7. Please also monitor his wound and give us a call if you notice any swelling or discharge. 3/3/26HISTOPATH RESULTS DIAGNOSISWell-differentiated dermal melanocytic neoplasm (excised)COMMENT/SThe mass appears excised, the narrowest inked lateral margin isapproximately 3 mm and the narrowest inked deep margin isapproximately 1 mm. In canine cutaneous melanocytic neoplasms, thismass exhibited features mostly suggestive of a more favourableprognosis. These included a low mitotic count (less than 3 mitoses in2.37 mm2), high amounts of pigmentation, a tumour thickness less than0.95 cm, lack of significant nuclear atypia (less than 20%), andrestriction of the neoplasm to the dermis without overt infiltrationinto the subcutis. Therefore, this warranted classification as a well-differentiated dermal melanocytic neoplasm.LK st Jann and advised of above Buzz doing well Recheck appointment on Friday     Vital Signs    Weight: 5.4;       

Appointment Reason: Dental procedure    Vital Signs    

Appointment Reason: Dental checkHISTORY:- Post-dental checkup, 6 months following procedure on 25/07/2025.- Previous procedure involved extraction of teeth 103, 301, 106 and removal of a lump identified as sebaceous gland hyperplasia/adenoma.- Presenting for assessment of teeth, with previous concern for teeth 104 and 204.- Owner also requesting removal of a lump located on the ventral aspect.- Reported to be bright, alert, and eating well, though avoiding hard items like bones.- Diet consists of meat, a homemade nut loaf with vegetables, and occasional chicken necks. Owner has concerns regarding chicken necks and potential dental damage.Current meds: noneProphylaxis: UTD.Pre-existing conditions: History of sebaceous gland hyperplasia/adenoma.EXAMINATION:Cardiovascular: cardiac auscultation normal, normal rhythmRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings but full neuro exam not performed todayMusculoskeletal: ambulating normallyGastrointestinal:- Oral: Concerns regarding teeth 104 and 204. Tartar on these teeth and some pain on palpation - Abdominal: no detectable pain on abdominal palpation- Rectal: Not performed.Integument/Ears: Lump present on ventral aspect of thorax. A second, smaller warty growth is present on dorsum, which is not of immediate concern to the owner.Lymph Nodes: NADEyes: NADPROBLEM LIST:- Dental disease affecting teeth 104 and 204 (upper canines).- Cutaneous mass, ventral aspect.DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Dental disease.- Cutaneous mass.ASSESSMENT:- Buzz presented for a 6-month post-dental recheck.- Examination and history indicate the need for further dental work, specifically extraction of the upper canine teeth (104 and 204).- A cutaneous mass on the ventral aspect is also noted for excision as per owner's request.- The plan is to perform a combined procedure for dental extractions and mass removal under general anaesthesia.CLIENT COMMUNICATION:- Discussed booking a procedure for dental extractions (104, 204) and lump removal for 27/02/2026.- Advised on the significant risks associated with upper canine extraction, specifically the potential for an oronasal fistula, and the requirement for a surgical flap and sutures.- Explained that pre-anaesthetic in-house bloods will be performed on the day of the procedure.- IV fluids will be administered during the procedure.- Discussed that pet insurance may provide some cover for the procedure.TREATMENT:- Nil in consult.PLAN:- Scheduled for general anaesthesia and surgery on 27/02/2026.- Procedure to include:    - Pre-anaesthetic in-house blood testing.    - Intravenous fluid therapy.    - Surgical extraction of teeth 104 and 204.    - Surgical excision of the ventral cutaneous mass.    - Full mouth scale and polish.- Owner to monitor for any changes and contact the clinic if concerns arise before the scheduled procedure.- Estimate $1800 same anaesthetic event    Vital Signs