C10009837 / invoice 10000

10/03/2026 NURSE: EH

REASON: Monthly recheck. Fainting episodes.

HISTORY:
- Previous seizure Christmas Eve. No seizures since.
- No coughing or fatigue reported. Sleeps a lot but has bursts of energy - running, playing tug-of-war.
- Galaprant working well when administered.
- No change to current meds
EDDU > Normal. No VDCS

CLINICIAL EXAM:
- Mentation: BAR
- MM: Pink, moist
- CRT: 1s
- Oral and Dental Score: Worn, G1-2
- Eyes: Bright and clear. Interesting eye positioning noted - may be positional, aligned.
- Ears: Clean
- BCS: Not assessed
- Lumps: R lateral thorax 1cm from midline - 1x1cm soft mobile cutaneous lump. L lateral thorax 7x5mm raised black lump. L ventral thorax left midline - 1x1cm soft subcut mass. L axillary - one large lump. Skin tag - getting bigger.
- Abdominal: Soft and comfortable. No organomegaly.
- Lymph nodes: Not assessed
- HR: 80 bpm. G2-3 heart murmur heard.
- RR: 28. Auscultation normal, WNL.
- Temp: Not assessed
- Urogenital: Not assessed
- MSK: Weight bearing well.
- Skin: Good coat.

ASSESSMENT:
- R lateral thorax lump - adipocytes on cytology.
- L lateral thorax lump - no distinguishable cells on cytology.
- L ventral thorax mass - not aspirated.

TREATMENT:
- FNA performed R lateral thorax and L lateral thorax lumps.

PLAN:
- Monitor L lateral thorax lump for growth/change.
- Monitor L ventral thorax mass.
- Recheck in 1/12.