C10009129 / invoice 10000

Reason: Lump Removal Admit + Cartrophne Inj Appointment Notes: SNDog reactive around other dogs  ------- Sms reply: YesHistory:Presents today fasted for lump removal. 2x 1. RHS of face 2. R axilla. Also needs cartrophen injection today EDUD okay, normal energy levels, no other concerns at home. Has been given 50mg traz prior to consult. Examine:Lump/s: 1. 15x10mm dermal RHS of face 2. 5x5cm SQ lipoma R axilla. BAR, mucus membranes pink, CRT < 2 secCardiac auscultation WNL, HR _100__ appropriate/good femoral pulsesRespiratory auscultation WNL, RR _20__Gums moist, no skin tenting or sunken eyes or evidence of dehydrationPalpable lymph nodes  WNLAbdominal palpation NADSkin and coat in good conditionLaboratory:PreGA bloods WNL Assessment: Fit for anesthesia/surgeryTreatment:Premed: medetomidine __0.001_mg/kg, Methadone 0.4 mg/kg SC IVC placedInduction: Propofol 5mg/kg slow IVIntubated and maintained on iso/02Hartmans _5__mls/kg/hr IV during GAMeloxicam __0.1__mg/kg sc post op No anesthetic complications occurred- HR, SPO2, resp remained WNLSkin around lump clipped and surgically preped.1. RHS face Elliptical incision with 5mm margins. Blunt dissection to remove. Closed SQ + intradermal with 2/0 monosyn. 2. R axilla Linear incision over lipoma. Blunt dissection to remove. Tacky sutures with 2/0 monosyn to close dead space. SQ + intradermal with 2/0 monosyn. No surgical complications occurred. Carttrophen given post op Plan:DischargeMedications to go home with: _Meloxicam SID starting tomorrow for 7 days ____Recheck in __7 days ____Strict exercise restriction + BC for lump removal from axilla. Expect some swelling and bruising given location. If too mobile higher risk of breakdown.    Vital Signs    Weight: 33;       

Reason: Small Lump/growth Sid Eof FaceAppointment Notes: SN  ------- Sms reply: YesHistory:Presents with small lump on side face that slowly grows and bleeds occasionallyAlso bit quieter laterly and known arthritis (currenlty giving 4cyte) - hesitates with jumpingEating and drinking normallyNo vomiting or diarrheaNo coughing or sneezingNormal energy levelsUrination normalEndo- and ectoparasite prevention: UTDExamine:Active and alertEyes and ears cleancrt<2, pulse normal, mm pink and moistHeart and resp sound normalAbd palp: soft and painlessLnn feel normalSkin: wart like skin tag narrow base on right side face of 1 cmAlos: 7cm lump under left arm pit - has been looked at in past lipomaDIfferential Diagnosis:Neoplasia benign vs malignantTreatment:Trazodone 100-200mg sidPlan:- To admit to hospital for small lump removal+consider removing or partly removing lipoma as may restrict gait and O confirmed is slowly growing. Est provided- to add PAB to ensue no systemic disease causing more quietness- To start cartrophen trial at admit - O asked for anti anxiety meds for occasioally being left and stressed and prior to vet visit, trazodone dispensed for trial    Vital Signs    Weight: 33.2;       

Reason: Meds ReviewAppointment Notes: jm  ------- Sms reply: YesHistory:Presents for lepto vaccination boosterEDUF fine, no concerns since last visitExamine:BAR, mm pink, CRT 1 secTreatment:Lepto vaccination 1ml given SC    Vital Signs    Weight: 32.3;