C10015741 / invoice 10000

Reason: Lump CheckAppointment Notes: Overdue remindersClient Present: Nicole (dog sitter)Nurse: MontanaVaccination: overdue Preventions: NGS UTDDiet: unsure of brand, dry food mixed in veges & wet food. Current meds & doses: nilWas HPP discussed?Insurance: Y - medibankif yes, Gaponly claim required today? YClient requests +/- concerns: no major concerns, does have hard poos every now and then and causes him to yelp, doesn't drink much water. Additional nurse notes:__________________________________________________________________________History: HISTORY:  Presented for a growing lump on the left angle of the jaw, approximately the size of a cherry. The house-sitter reports her son and husband noticed the growth. The owner previously mentioned a lump described as an 'old man' lump, but no previous clinical records are available. The primary vet is Papagenet Corrara. The lump is mobile on palpation. Reports occasional vocalisation during defecation. Diet consists of biscuits, warmed frozen vegetables, and tinned wet food. Some licking of himself noted, but no specific areas of concern. Current meds: noneVaccination: Overdue since July 2025.Parasite Prevention: UTD. Nexgard Spectra.Pre-existing conditions: noneAccess to toxins eg. Rodenticide: none EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:Oral: normal, no mouth pain, dental score (1-4): not graded. Plaque noted on teeth.Abdominal: no detectable pain on abdominal palpationRectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: NSFLymph Nodes: NSFEyes: NSFDemeanour/Behaviour: not discussed PROBLEM LIST:Growing mass on the left angle of the jaw.Overdue vaccinations.Dental plaque. DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Suspected soft tissue sarcoma based on cytology. DIAGNOSTICS:Fine needle aspirate of the left mandibular mass was performed.Under the microscope, significant pleomorphism (variability in cell size and shape) was observed.Cigar-like cells were noted, indicative of fibrous type tumours, possibly mesenchymal in origin, sitting in a row.Concern for soft tissue sarcoma.The slide will be sent to a clinical cytologist for further evaluation and guidance. ASSESSMENT: Presented for a growing, mobile, cherry-sized mass on the left angle of the jaw. Cytology is concerning for a soft tissue sarcoma. Plan is to send the slide for external review by a clinical cytologist before proceeding with surgical excision. The patient's vaccinations are overdue and there is dental plaque present. TREATMENT:  Discharged home pending cytology results. PLAN:Send cytology slide to a clinical cytologist for review.Await results to guide surgical planning.Once results are available, look to book for surgical excision of the mass.A customised quote for surgery and optional dental work has been provided.The priority is the lump removal, with wide margins if indicated.Dental procedure (scale, polish, dental X-rays) can be performed concurrently to maximise the anaesthetic time if the owner consents.Follow up with the house-sitter/owner once cytology results are received.Home into house-sitter's care. CLIENT COMMUNICATION:Discussed the findings of the fine needle aspirate with the house-sitter, Nicole. Explained that the cells are suspicious for a soft tissue sarcoma, but this is not a definitive diagnosis based on cytology alone. Recommended sending the slide to a specialist cytologist for confirmation and further guidance on how aggressively the lump needs to be removed. Explained that because of the location, wide surgical margins could be challenging but the mobility of the mass is advantageous.Provided a detailed quote for the lump removal, histopathology, and all associated costs, including post-operative checks, totalling approximately $2600.An optional dental procedure (survey, X-ray, clean) was also quoted as an add-on for approximately $500, making the total with dental work $3100.Advised the house-sitter to forward the quote to the owner in China for pre-approval from their pet insurance, noting that dental work is often not covered. Discussed the option of splitting the invoice for insurance purposes. The house-sitter will pay and be reimbursed by the owner. Agreed to proceed with sending the cytology for external review.Examination: Laboratory: Assessment: Treatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Plan: Scripts Needed - Yes or NoRevisit needed - Yes or No - ____ Days pleaseReason: Nurse: -vaccination -heartworm -worming -flea/ticks Exam: Lab: Assessment: Treatment: Plan:    Vital Signs    Weight: 6;       

Reason: GHC & Stay For Dental CCEO Appointment Notes: Sasha approved to book Will bring Happy in fasted from 8pm tonight (22/7) O goes overseas on Friday and wanting to get teeth cleaned before she leaves. Confirmed who is looking after him when she is away is okay to care for him after GA if needing teeth out etc. Quoted $102 for cons, all other fees to be disucssed at appt. Overdue remindersClient Present: Lisa.Owner was overseas last few years, friend was looking after himFriend possibly took to Greencross Helensvale Now owner, lisa is back.Nurse: JTMay need teeth cleaningGone through HPP + preventatives + vaccineDiscussde signing up HPP for dental benefit + vacc + hw test + bloods Vaccination Type: Last vaccinated 2022Intestinal worming: Likely not UTD, unsure Heartworm Prevention: Likely not UTD, unsure but none on file Flea Prevention: as aboveTick control: as aboveMicrochip: on file Insurance and Healthy Pets Plus: neither, maybe hpp today Behaviour concerns: none Current medications: none Current Diet:Type of Shampoo/Frequency:Toileting: no concerns__________________________________________________________________________History: Owner was away for few years and he was left with friend. Would like full body check. Presented for grade 3 dental. Hasnt eaten after 8pm last night. Been well.Examination: BARMms pink and moist  CRT<2CVS: no murmur or arrythmiaResp: normal effort and BV soundsAbdomen: comfortable palpation, no massMSK: MPL on RHL G3Laboratory: Pre GA - CBC Biochem eletrolyte - all WNL HW test negative Assessment: G3 MPL on the RHLFit for dentalDental:Premed:methadone 0.2mg/kg IV, ACP 0.02mg/kg IVInduction: alfaxolone to effectMaintanence: isoflurane and oxygenIVFT: Hartmanns @5ml/kg/hrETT mmComplications: nilTop up with 0.1mg/kg methadone IV on recoveryTo monitor 104Routine dental scale and polish without extractions* Missing - noneTreatment: Anal glands expressed very full bilaterally C4 vaccinaiton SCKC vaccination PONails clippedPlan: TGH with following instructions:- Recheck 3 days post dental- Gone through dental home careTo start on NGSBooster in one month--- 24/07/2024 10:24:21 AM HCY:Examinations - Resolved - called. No answer. LMOM CRH--- 24/07/2024 10:24:24 AM HCY:Dental / Oral - Resolved ---- 24/07/2024 10:24:26 AM HCY:Radiology - Resolved ---- 24/07/2024 10:24:28 AM HCY:Vaccinations - Resolved -    Vital Signs    Weight: 6.2;       

Reason: Health Check & VaccineAppointment Notes: MJSubjective: Had dog for about a year, adopted from friend who moved overseas. EDDU well. No concerns. UTD with preventions. Objective: BAR, mm pk+m crt<2sec. EEN wnl. G2dd. Cardiac ausc wnl. Lung sounds clear. Abdo palp soft and comfortable. Ambulating well. WBx4. LNs wnl. G grade 1 MPLLaboratory: Assessment: Given C4 and oral BBPlan: Given estimate for G2 dentalConsent has been given by the client to proceed with this treatment  -  Yes--- 24/03/2022 08:10:28 AM MC0:Vaccinations - Resolved -    Vital Signs    Weight: 6.6;       HeartRate: 100;       DentalGrade: 2;       Temperature: 38;       CRT: <2;       MMColour: pk+m;       BodyScore: 6;