C10002129 / invoice 10000

Species:CANINE
Breed:Golden Retriever
Age (years):10
Diagnosis or signs:Lump/s
Consult notes
07/03/2026 Reason: Check lumps

History:
Ears worrying him last 7 days, shaking head occasionally but no redness or discharge so O is worried there is something in there
Has hx of ear infections, has been cleaning with Epiotic
Also has a couple of lumps: one on back between shoulder blades, one on LH digit 4, dorsal surface - both started as lumps on the skin but have got red and irritate and bled
Riley has been licking at LH paw incessantly
EDUF all ok
No v/d/c/s
Good energy levels, seems otherwise well - limping settled down nicely with some carprofen
On apoquel 1 x 16mg SID, normally well controlled but licking paws a lot lately

PE:
BAR, goofy boy
MM pink, moist
CRT <2s
HR 120, sounds NAD
Lung sounds NAD
PLN NAD
EENO - ears look ok externally, otoscopic exam seemed painful in R ear, mildly erythematous in vertical canals. Swabs show debris only, no significant bacteria or yeast
Dental - gr 2/4
Integument - lump on LH digit 4, dorsal surface - cutaneous, approx 0.5cm diameter, appears to be a healing wound, saliva staining all around. No significant swelling or discharge associated. Lump on back between shoulder blades - cutaneous, approx 1cm diameter, wound on top with raw area, sits right underneath harness. Appears consistent with skin tag.
Abdo soft, comfortable
MSK no lameness, stiff gait, L stifle extremely thickened (prev CCL lig sx)
Urogenital NAD
BCS 7/9

Assessment:
Mild inflammatory otitis externa
Lumps appear to be infected/inflamed skin tags

Plan:
Offered Elocon lotion for ears, declined for now - will clean daily for a few days with Epiotic and do apoquel BID for up to 2 weeks as needed to settle allergies (understands this is off label)
Home with Neocort cream for lumps, use for about a week then if lumps still causing concern revisit and we can attempt to sample.
Use e-collar as needed to stop licking

Animal clinical history (3 most recent)

2026-03-07T00:00:00Z 15:32:51
Reason: Check lumps

History:
Ears worrying him last 7 days, shaking head occasionally but no redness or discharge so O is worried there is something in there
Has hx of ear infections, has been cleaning with Epiotic
Also has a couple of lumps: one on back between shoulder blades, one on LH digit 4, dorsal surface - both started as lumps on the skin but have got red and irritate and bled
Riley has been licking at LH paw incessantly
EDUF all ok
No v/d/c/s
Good energy levels, seems otherwise well - limping settled down nicely with some carprofen
On apoquel 1 x 16mg SID, normally well controlled but licking paws a lot lately

PE:
BAR, goofy boy
MM pink, moist
CRT <2s
HR 120, sounds NAD
Lung sounds NAD
PLN NAD
EENO - ears look ok externally, otoscopic exam seemed painful in R ear, mildly erythematous in vertical canals. Swabs show debris only, no significant bacteria or yeast
Dental - gr 2/4
Integument - lump on LH digit 4, dorsal surface - cutaneous, approx 0.5cm diameter, appears to be a healing wound, saliva staining all around. No significant swelling or discharge associated. Lump on back between shoulder blades - cutaneous, approx 1cm diameter, wound on top with raw area, sits right underneath harness. Appears consistent with skin tag.
Abdo soft, comfortable
MSK no lameness, stiff gait, L stifle extremely thickened (prev CCL lig sx)
Urogenital NAD
BCS 7/9

Assessment:
Mild inflammatory otitis externa
Lumps appear to be infected/inflamed skin tags

Plan:
Offered Elocon lotion for ears, declined for now - will clean daily for a few days with Epiotic and do apoquel BID for up to 2 weeks as needed to settle allergies (understands this is off label)
Home with Neocort cream for lumps, use for about a week then if lumps still causing concern revisit and we can attempt to sample.
Use e-collar as needed to stop licking

Previous claim history (23)

DateClaim #Diagnosis
2026-02-21C09937895GAIT ABNORMALITY - LAMENESS - PRESENTING COMPLAINT
2026-02-21C09938025GAIT ABNORMALITY - LAMENESS - PRESENTING COMPLAINT
2026-02-21C09995142HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2026-01-18C09819502HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2024-07-01C7411003SPRAIN
2024-06-13C7389637HYPERSENSITIVITY DISORDER (ALLERGY)
2024-04-05C7118980HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2024-03-20C7021238PRURITUS - PRESENTING COMPLAINT
2024-02-22C6912477HYPERSENSITIVITY (ALLERGIC) SKIN DISORDER
2024-01-02C6708687ALLERGY
2023-09-01C6272082MASS LESION - SKIN (CUTANEOUS)
2022-09-10C5092148ALLERGY
2022-07-09C4908315DERMATITIS - PYOTRAUMATIC (ACUTE MOIST)
2022-02-01C4447420OTITIS EXTERNA
2022-01-21C4422488OTITIS EXTERNA
2021-01-29C3485037HEARTWORM TEST OR BLOOD SCREEN
2021-01-29C3485037ANAL SAC ABSCESS
2021-01-28C3485848ANAL SAC ABSCESS
2021-01-20C3461622ANAL SAC ABSCESS
2021-01-18C3456416ANAL SAC ABSCESS
2018-05-13C1701389INSECT BITE/STING
2017-07-10C1250475MISCELLANEOUS CONDITIONS
2017-07-02C1281812KENNEL COUGH

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_consultation109.002026-03-07
20000tstarc_skin_medication_-_topical_antibiotics_and_anti-inflammatory53.542026-03-07
30000tstarc_diagnostic_test_-_cytology68.002026-03-07

UPM+

  • DG02720MASS LESION - SKIN (CUTANEOUS)DSTP_mass_lesion_-_unspecified
  • DG01185OTITIS EXTERNADSTP_otitis_externa

Variant (sleepy_king)

HYPERSENSITIVITY DISORDER (ALLERGY)
DSTP_skin_-_allergic_disorder
Conf: 0.330
Threshold: 0.38
Above:
Correct?
Reason (correct)