C10010636 / invoice 10000

Leptospirosis booster- Nurse + REVISIT LUMp

Nurse Injection

Name, strength, volume and route given of medication:
Lepto booster 1ml sc base of neck 

Initials of vet who authorised repeat:
HMG

Health update of patient:
going well 

Behaviour of patient:
good boy 

Batch number:
Expiry: 


Recheck lump on LF carpus
not much change after antibiotics
repeat FNA
poorly exfoliating
3-4 spindle looking cells on slide
no other definitive cell types present

concern re spindle cell mass
recommend excision
warned narrow marhgins given location but histopathology so know what we are dealing with
may require secondary revision surgery if nasty but can plan more graft etc if required

discuss at home
estimate on file $1800-2000 if decide to book in

REASON = Vaccination

HISTORY =
- Going well at home, EDDU ok
- OR LFL lump appeared about 4mths ago, Benji licking it recently. Hasn't really changed in size. No lameness
- Diet = Advance dry
- No current medications
- UTD with bravecto chew
- Overdue vaccinations + Sr12 by >1yr. Recd HWT x2 6mths apart, O consented
- Recd start lepto course --> O consented

PE =
- Eyes/ears/nose NAD
- Teeth 0/4
- Chest NAD
- Abdo palp NAD
- BCS 6.5/9
- LFL - medial antebrachium - dermoid/subcutaneous mass, grape size, semi-firm. Can feel something stiff/sharp on ventral aspect, dried discharge/saliva over hair on this part. Clipped --> used haemostats to remove lots of hair follicles but no FB found. FNA = RBCs ++++ occasinoal neutrophil, macrophage, mast cell
- HWT = negative

ASSESSMENT =
- Ddx (lump) - furunculosis, chronic FB, other inflammatory lesions, benign neoplasia, malignant neoplasia
- Overweight

PLAN =
- Gave Canigen KC SC. Next due in 1yr.
- Gave Nobivac Lepto 2 SC. Next due in 1yr.
- Gave Proheart Sr12 1.7ml SC. Next due in 1yr.
- Recd ABs for 1wk then recheck FNA. If still inconclusive then excisional biopsy/explore. Can do at 2nd lepto so start ABs a week before this appointment
- TGH amoxyclav 15mg/kg (500mg) PO BID for 7 days
- Recd weight loss, aim for 28kg
- Next HWT in 6mths

Doing good, back to normal, EDUD all normal. KB