C10012521 / invoice 10000

History: onging managemnet at animalius 
recently added in galliprant + fenofibrate (reduce triglyceride)
o's noted that one of his lumps has grown rapidly/changed in appearance
o's interested in sx removal of this and other lumps, dental s/p while under GA if all okay 

Objective:BAR nervous shaking (normal for mo chara)
MM:Pink
CRT: 2 sec
Eyes: NAD
Ears: NAD
LN's: NAD
Skin: LHS proximal neck red/ulcerated dermal wart, LHS muzzle 4mm dermal dark wart, RHS lateral hock 4mm flat dark dermal wart  
large soft s/c mass ventral chest 
Abdo: NAD
MS: NAD
Urogen: NAD
BCS: 6/9
Dental: grade 1-2 no obvious extractions, no lip/oral masses 

Assessment: superficial warts > L face/neck changed in appearance  
likely lipoma ventral chest 
mild dental disease 

Treatment:nil current 

Plan:surgical removal of masses (see body map) + dental s/p if GA going well. #thorough oral exam as OR oral mass removed in past
increase galliprant to SID post op period ? as only on EOD currently 

Email from animalius 

Dear Dr Whitehead,

Please find attached an update on patient Mo Chara Grace who was recently seen by the Animalius team.  I have recommended a revisit with you to discuss removal of a lesion on the left side of his face that has changed in character.  It may be a cutaneous haemangioma/sarcoma based on gross appearance, with histopathology recommended.  The owner also commented they were concerned about the tartar build up on his teeth also so suggested they see if you were open to mass removal and dental treatment at the same time.  

Mo Chara is also struggling with mobility and given his other comorbid issues, I have prescribed galliprant to use in conjunction with his pentosan injections to see if this helps his everyday quality of life.  Hoping this is ok.

I am not due to see Mo Chara for 3 months (fasted liver monitoring and blood fat check) but please don't hesitate to reach out if there are any concerns prior.

Kind regards,

Fleur

presenting for final zydax 
doing well seems more mobile/running around a bit more 

tx; zydax 0.9ml s.c 

plan; zydax q6months 
monitor panting, chest clear/nsf on exam - if worsening/coughing occuring then recheck and likely chest radiographs