C09999234 / invoice 10000

Reason: Growth On ElbowHistory: Dbol's digestive issues seem to have settled with tuna & rice over the last 3-4 weeks, so think he may have a chicken allergy. Has a growth on the inner aspect of the right elbow - has been checked out previously, but has now developed another growth next to this which is bloody and purulent. Doesn't seem to be bothering him. Otherwise well with normal energy levels & EDUF. No diarrhoea, blood but orange in colour. Notice mucous coating on the stool approximately once weekly. Does tend to sunbake.Diet: tuna or caned salmon + rice + freeze dried beef liver snaclssPreventatives; nexgard spectra UTDMedication: none Objective: Bright, alert and responsive. Weight loss of 490 grams. Eyes/ears/nose: NAD. Mouth: grade 1-2 dental disease. Integument: pink, hairless pedunculated mass medial aspect of the left elbow - FNA did not yield any cells, with cystic mass immediately adjacent - completely deflated with FNA - leaked haemorrhagic liquid - cytology reveals erythrocytes + neutrophils. No bacteria visualised. No other cells visualised. Thoracic auscultation: grade III/VI left apical systolic heart murmur, thoracic ausculttation otherwise NAD. Abdominal palpation NAD. Peripheral lymph nodes NAD.Assessment: Cutaneous mass medial aspect of left elbow with cyst adjacent.Chronic enteropathy - diet responsive - food allergy vs IBD main rule outsPlan: Diltue chlorhexidine wash of elbow where FNA's performed. Owner to consider whether wishes to pursue biopsy for histopathology for further assessment. If keen to do this, advised would recommend echocardiorgam with DL first - estimate $800-900. Owner to gradually transition across to either seafood based diet or hydrolysed diet to ensure appropriately balanced meals.    Vital Signs    Weight: 30.08;       MMColour: pink;       HeartRate: 100;       BodyScore: 5/9;       DentalGrade: 1-2;       CRT: < 2 sec;