C10003426 / invoice 10000

Reason: Lump On Throat? Unwell TodayAppointment Notes: called 1.10pm unsure if she will come or not??Consultation time: 16.25History:Presenting problem:  Owner states that Misty seemed normal until yesterday.  Noticed a lump on the left ventral neck by yesterday afternoon., seems to be getting bigger.Also lethargic and very interested in food.Lost weight  in the last 2 weeks .O was at the vets 2 weeks ago for three monthly cartrophen inj for the knee issues Previous medical history/medications:  Heart murmur 4/6 - Managed with cardisure 2.5 mg  Had knee surgery twice in the same leg for cruciate disease , 5 years agoExamine:  Demeanour - T: 38.7      HR: 140       RR:  20   mm:   pink   CRT: < 2 wecWeight: 7.65  kg       BCS: 5 /9Good teeth Grade 1-2 /4 Cardiovascular: 4/6 murmur or arrhythmia, synchronous femoral pulsesRespiratory: Normal BVS and effort bilaterally Gastrointestinal: NADUrogenital: NSF outwardly.  MSK: Had knee surgery 5 years ago. Arthritis present.Neuro: Normal mentation, no ataxia. Full neurological exam not performed.Eyes.- NADIntegument: Soft swelling in the ventral neck spreading the whole ventral neck area, with minimal bellowing.LNs: Peripheral LNs WNR Problem list:Swollen ventral neck Assessment: DDX: Allergic reaction, FB entrapment , hypo proteinemia, Liver disease , Right sided heart failure less likely tooth root abscess. Client communication:Offered admission for further work upper respiratory infection including bloods, imaging and treatment as needed.Symptomatic treatment.O declined further work up today , decided to take Misty home after the symptomatic treatment. Treatment:  Niramine 0.5 ml SC inj  Start on NSAID for 3-5 days Plan:Home to monitor and revisit should there be any concerns.Revisit at the regular vet in 3-5 days    Vital Signs    Weight: 7.65;