C10001998 / invoice 10000

Reason:R hock -- pressure sore like callusVerified: NoHISTORYPresenting for: Mia, a 10-year-old female dog, presented for follow-up consultation regarding a small lung nodule detected on CT scan and assessment of a lesion on the elbow.Historical Conditions:- Previous lung tumour surgically removed from left lung approximately 2 years ago- Recent abdominal wall mass surgically excised in February 2025 with complete extension achieved- Stifle mass also surgically removed in February 2025- Additional mass discovered and removed during recent surgery, suspected liposarcoma- Small lung nodule detected on CT scan, unchanged in size over 3-4 months across 3 sequential scans- History of multiple soft tissue sarcomas (low grade, operable)- Prone to developing sarcomas rather than benign lipomasCurrent Meds:- Insurance coverage in place, obtained after primary lung tumour diagnosisEXAMMentation: BARIntegumentary:- Elbow lesion on same leg as previous stifle surgery: crusty lesion consistent with callous formation/pressure sore, non-painful, not concerning- Patient appears to have recovered well from recent February surgeryASSESSMENTSmall pulmonary nodule - stable size over 3-4 months, likely separate lesion rather than metastasis from previous lung tumour given lack of widespread pulmonary involvement and time courseElbow callous formation - consistent with pressure sore, benign appearancePost-surgical recovery - patient recovering well from February abdominal wall and stifle mass excisionsPLANDiagnostics:- CT scan recommended to re-evaluate lung nodule prior to surgical planning- Surgical removal of lung nodule recommended in approximately 2 months (around April/Easter) once patient fully recovered from previous procedures- Pre-approval with insurance company to be pursued for lung nodule removalAdditional Discussion:- Specialist confident in ability to remove small lung nodule when patient ready- Patient clinically stable and has recovered well from recent surgeries- Low grade nature of previous tumours and successful surgical management discussed- Insurance coverage may be complicated due to policy initiation after primary lung tumour, but lung nodule likely represents new growth rather than metastasis- Patient's good recovery and young appearance for 10 years of age noted- Plan to proceed with lung nodule removal around Easter timeframe once fully recovered    Vital Signs    Weight: 18.55;