C09998835 / invoice 10000
Species:CANINE
Breed:Cavoodle
Age (years):11
Diagnosis or signs:Lump removals
Consult notes
<html><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><div> <div> <div> <p>Reason: lump removals<br><br>History: Has been generally well, no concerns at present, on cyclosporine, pimobendan and ursodiol currently.<br>Given pimobendan early this morning with very small amount wet food.<br>Multiple papillomatous lumps over bleeding - ones over left shoulder, left upper lip and upper LHL bleeding and crusty.<br>Also additional papillomatous lumps over left neck (base of ear), dorsal rump area, and lipomas over ventral chest and R shoulder area.<br>Priority to removal bleeding/crusty papillomatous lumps and then others if GA stable.<br>Os have also noticed making a few more snorty/retchy noises recently<br><br>Examine: BAR, mm pink, grade 2 POD, lungs clear, HR 96, grade 3-4/6 left systolic lung murmur, lungs clear, multiple papillomatous lumps as listed above.<br><br>Treatment:<br>22g catheter placed RF, sterile prep<br>Premed with 0.2mg/kg midazolam and 0.01mg/kg buprenorphine i/v (0.52mL)<br>Induced 1mg/kg alfaxan i/v, 7.0 ET tube, iso/O2 maintenance<br>No laryngeal abnormalities noted during intubation<br><br>Removed papillomas over L shoulder, L upper lip, upper LHL, dorsal rump area - all with narrow margins, single 3-0 filapron absorbable suture placed in s/c placed in all sites except lip, skin closed with 3-0 filamide simple interrupted sutures.<br>HR stable but breathing up under despite suitable depth of GA.<br>Elect not to remove lipomas today - will need to book in for another time.<br><br>Woke up quickly, additional 0.1mg/kg midazolam given i/v during recovery to help settle<br>STO and updated, ok TGH this aftenroon, resee 2 weeks for s/r<br>TGH with amoxyclav 250mg BID 5d, paracetamol 125mg BID as necessary for additional pain relief if required<br><br><br></p> </div> </div> </div></html>
Animal clinical history (3 most recent)
2026-01-13T00:00:00Z 17:44:00
O almost out of CardisureOk to dispense another box - Cardisure 5mg - 3/4 tablet twice a day, give an hour before foodScript written for O to order more Cardisure next time
2025-12-23T00:00:00Z 09:00:00
Reason: dispense Cardisure and UrsodiolOk to dispense Cardisure 5mg - 3/4 tablet twice a day, give one hour before foodTo start on medication and look to book in for lump removals in JanuaryAlso dispense BOVA Ursodiol 200mg x 100 capsules, one capsule once a day - recent blood results stable (ALT 146, ALP 599).
2025-12-11T00:00:00Z 10:00:00
Reason: check lumps, bloods, cardiac ultrasoundHistory: Overall has been well, currently on cyclosporine 4 times a week - stable with eyes, ursodiol 200mg SID, rose hip vital and synbiotic. Warty lump over L shoulder more crusty and bleeding more frequently, also developed new lump over R cheek and back of head/neck area. Appetite, water intake and toileting all ok. Good with exercise - no changes noted.O would like to get lumps removed likely early next year.Examine: BAR, mm pink, grade I-II POD, eyes open and comfortable - mildly inflammed conjunctiva, grade 3-4/6 systolic murmur, HR 120, lungs clear, NSF on abdo palpation but difficult to feel good detail, BCS 7/9.4-5cm lipomas over ventral chest and L chest wall, multiple papillomatous lumps - largest one L shoulder area, also smaller ones - R upper cheek, back of head/neck (not able to find this one today), dorsal rump, L upper thigh.Fatty deposits over lumbar area and chest wall - symmetrical and present on both sides so suspect are not lipomas.Plan: recheck bloods and cardiac ultrasound given borderline B1/B2 at last scan, likely to need to start on pimobendan prior to planned GA/lump removal.Blood collected for non-interpreted profile.Cardiac ultrasoundLVIDDn 2.02, La:Ao 1.59, LA enlarged in short/long axis, EPSS 3.2mm, FS 33.8%.Moderate volume mitral, and small volume tricuspid and pulmonic insufficiencies as previouslyMRV 6.2m/s, 155.5mmHgTRV 2.7m/s, 29.5mmHgMitral E 0.91, A 0.76, E/A 1.19.Assessment: stage B2 degenerative mitral valve disease and clinically insignificant tricuspid and pulmonic insufficienciesPlan: recommend start pimobendan 3.75mg BID for at least 2 weeks prior to GA, repeat echo in 6-12 months - sooner if increase in murmur intensity or development of clinical signsAwait blood results then to organise date to book in for lump removals.
Previous claim history (2)
| Date | Claim # | Diagnosis |
|---|---|---|
| 2025-12-11 | C09614822 | HEPATOPATHY (LIVER DISORDER) |
| 2025-12-11 | C09614822 | HEART (CARDIAC) VALVE DISORDER |
Line items(lines with upstream diagnosis are skipped by the model)
| Line | tstarc | Amount | Date | Upstream diagnosis |
|---|---|---|---|---|
| 10000 | tstarc_sedation_for_procedure | 85.00 | 2026-03-02 | — |
| 20000 | tstarc_midazolam | 51.17 | 2026-03-02 | — |
| 30000 | tstarc_anaesthesia_-_inhalation_anaesthetic | 225.00 | 2026-03-02 | — |
| 40000 | tstarc_fluid_therapy | 155.00 | 2026-03-02 | — |
| 50000 | tstarc_surgery_fee | 495.00 | 2026-03-02 | — |
| 60000 | tstarc_nursing_care | 155.00 | 2026-03-02 | — |
| 70000 | tstarc_anaesthesia_-_alfaxan | 29.10 | 2026-03-02 | — |
| 80000 | tstarc_antibiotics_-_amoxicillin_and_clavulanic_acid | 33.20 | 2026-03-02 | — |
| 90000 | tstarc_theatre_fee | 225.00 | 2026-03-02 | — |
UPM+
- DG01224PAPILLOMA, SOLITARY - OTHERDSTP_papilloma_or_wart
Variant (sleepy_king)
MASS LESION
DSTP_mass_lesion_-_unspecified
Conf: 0.810
Threshold: 0.44
Above: ✓
Correct?
Acceptable?
Reason (acceptable)
Diagnosis description