C10008326 / invoice 10000

10/03/2026 Diagnosis: Anal sac adenocarcinoma (right), resected 29/5. Suspect Stage I/II (query IIIA based on 8 mm bilateral internal iliac lymph nodes). Sarcoma arising from complex nodular hyperplasia. Immunohistochemistry is consistent with this being a nonhistiocytic-, nonendothelial cell- sarcoma. Carboplatin x2, Mitoxantrone #6/6 (as progression of internal iliac on carboplatin). Palladia revisit

History: Missy began having diarrhoea during chemotherapy. It continued until owner switched form Lyka to HIll's GI Biome. While on Hill's, her faeces was completely normal.  Diarrhoea would return whenever Lyka was reintroduced. Missy has since transitioned to Scratch raw diet, which seems to be well tolerated though this morning the second half of her droppings was loose. 


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Physical Examination findings: Bright, alert and responsive. Oral examination notes some minor dental disease, otherwise unremarkable. Peripheral lymph nodes palpating normally. Heart and lungs unremarkable. Abdominal palpation soft and comfortable. Rectal examination unremarkable. 
Mm pink, crt < 2 secs, HR 110 RR 20 Temp 38.5 Wt: 22.4 kg. 

Laboratory results: CBC performed in house with manual blood film assessment.
Hct: 0.326
WCC:5.63
Neuts:3.44
Platelets:205

Manual differential count:  Neutrophils 54%, Lymphocytes 35%, Monocytes9 %, Eosinophils 2%.
Platelets: clumped and adequate
Morphology: Normal 

Procedures: Procedures: Abdominal ultrasound: sedated and fasted
Sedation: Domitor (5mcg/kg), butorphanol (0.2mg/kg) IV; later reversed with antisedan IM (equal volume). 

- The liver appeared homogenous with smooth, regular borders;  one small hyperechoic liver lesion was noted 0.87 x 0.7 cm (suspect myelolipoma), no other lesions were appreciated. The gall bladder had smooth regular walls with anechoic fluid within the lumen.  
- The spleen was absent.
- The left and right kidneys were within normal with normal corticomedullary definition.  The right and left adrenal glands were visualized and were within normal.  
-Both left and right medial iliac lymph nodes were within normal size. 
-The internal iliac lymph nodes from the left measure 0.84 x 1.46 cm (was 0.7 x 1.24 cm) . From the right the caudal measured 0.89 x 1.07 cm (0.62 x 1.43 cm) and the cranial measured 0.41 x 0.46 cm (was 0.61 x 1.43 cm). Based on previous measurements this represents stable disease. 
-There was no free fluid. 


Treatment: xmg x was administered IV via a 22g catheter in the x vein using the closed injection Equashield system.

Comments: 

We will see Missy again in x weeks time.  Please feel free to call or email if you have any further queries regarding Missy.