C10015906 / invoice 10000

Lump Removal

Surgery - 2x lump removal 

PRE- ANAESTHETIC EXAMINATION:
Mentation: (BAR, anxious)
CVS: HR (108) bpm. Normal heart sounds and rhythm. Normal pulses with no deficits. 
MMs pink, moist. CRT <2 secs, skin tenting (nil).
Resp: RR (24bpm). Normal resp rate and effort. Normal lung sounds auscultated. No cough elicited on tracheal palpation.
Abdomen: (NAD on palpation, nil distension)
Temp: (N/A)

PRE-ANAESTHETIC BLOOD TESTS:
(Mild eosinophilia - possible indication of parasites or allergies, will recommend to worm with drontal at discharge today)
Other parameters are within reference ranges

ANAESTHESIA:
Pre-medication: Medetomidine @ 0.03mg/kg (1.14)mL + Methadone @ 0.3mg/kg (1.14)mL SC.
Induction: Alfaxan @ (2)mg/kg (7.6)mL IV. 
Maintenance: Isofluorane + Oxygen supplied via ET tube.
IVFT: Hartmanns (5)mL/kg/hr
Active warming in the form of blankets/hot water bottles/socks used to maintain normothermia

PROCEDURE:
Type of procedure: (lump removal 2x)
Recumbency: (dorsal recumbency)
Site: (1x 4x4cm soft mobile cutaneous lump one left ventral abdomen, 1x 1x1cm soft mobile cutaneous lump on left dorsal foot)
Findings: (Mast cell tumour characteristics, will send both samples to QML for histology)
Closure: (2-0 PDS subcutaneous layer, 2-0 supramid skin layer)

POST-SURGICAL CARE:
Uneventful recovery
Medications: (Loxicom 1.6ml SC)

PLAN:
Post-operative care notes given to client on discharge
Medication to take home: (Previcox 227mg 3 tablets, give once a day with food starting Thursday 12/03/2026)
Recheck in 10-14 days for suture removal
Requested they return sooner if any concerns during recovery period.
E-collar placed

Lumps & Bumps
Type: Consult - Non Emergency Injury/Illness
Client Name: Tessa Hutchinson
Mobile: 0497257194
Email: tessa.mcconkey@live.com
Patient Name: Panda
Notes: VETSTORIA - Panda (Dog) Tessa Hutchinson (0497257194 - tessa.mcconkey@live.com) - Consult - Non Emergency Injury/Illness (Reassess condition - Inflammatory GI disease - bloods taken Oct 25 showing extremely low calcium and b12. Have switched to hypoallergenic diet which has improved symptoms. She has a lump on her left side which has been th

Verified: YES

HISTORY
Presenting for: Panda presented for recheck following IBD diagnosis in October and evaluation of skin lumps
Historical Conditions: IBD diagnosed October 2025 with low B12 and calcium on bloodwork; lifelong history of abdominal issues and pancreatitis; switched to hypoallergenic diet in October with significant improvement in appetite, energy, and stool quality; one lump present for years, previously monitored by vet with advice to watch for changes
Diet: Hypoallergenic diet since October; appetite significantly improved, now finishes meals before other dog
Current Meds: High strength B12 supplement from pharmacy given with dinner nightly (currently out and needs refill); 

EXAM
Mentation: BAR. Nervy dog so limited examination. 
Wt: 37 kg
BCS: 5/9
T: NT
MM: pink and moist, CRT <2
Behavioural: Does not like stethoscope; accepts treats during exam
Oral: moderate tartar on teeth
Abdominal: soft and loose, no fluid wave or intra-abdominal masses palpable. 
Lymph Nodes: WNL
Integumentary: Cutaneous mass on L side of ventral abdomen, approx 4cm across, recently developed purplish tinge - soft, mobile, not attached to underlying structures; multiple small warty growths present on body and foot
Musculoskeletal: Hips normal, no lameness observed
Diagnostics: Fine needle aspirate of large skin mass - cytology consistent with mast cell tumour

ASSESSMENT
Mast cell tumour - cytologically confirmed, fairly nasty and aggressive cancer type but well confined within skin allowing for adequate surgical margins

PLAN
Diagnostics:
- Pre-anaesthetic bloodwork recommended given age
- Histopathology of excised mass to confirm diagnosis and margins (optional)
Medications/Treatments:
- Antihistamine tablets administered (2 tablets for 7kg patient) to suppress immune stimulation following needle aspirate
New Meds/Tx:
- Surgical excision of mast cell tumour with 3cm margins recommended as soon as possible
- Post-operative pain relief
Additional Discussion:
- Cost estimate provided for surgical removal including anaesthesia (30 minutes surgical time estimated), pre-anaesthetic bloods, and histopathology
- Sooner surgery performed, better margins achievable
- Chronic allergic response can sometimes mimic mast cell tumour on cytology but unlikely in this case