C10016404 / invoice 10000

<p>History:<br>Multiple lumps present. One lump has been fluctuating in size over past 2 weeks, now leaking and showing rapid growth with swelling. One lump consistently flares up then reduces. Small lump has not increased in size. Previous cytology performed on lumps approximately 30 months ago.</p><p>Preventatives:</p><p>Diet:</p><p>Current medications:</p><p>Examination - <br>FAS score: <br>Behaviour: BAR<br>Neurological: Proprioception and mentation normal<br>Eyes: Open, comfortable, no discharge<br>Ears: Clean, no discharge<br>Teeth: <br>PLN: No lymphadenopathy<br>Respiratory: Normal bronchovesicular sounds<br>Cardiovascular: MM pink, moist CRT <2s, Heart regular rhythm<br>Abdomen: relaxed, soft and comfortable, no masses palpable<br>Integument: Multiple cutaneous masses present - one large swollen ulcerative mass on chest showing rapid growth and leakage, one mass that fluctuates in size, one smaller stable mass<br>Musculoskeletal: No pain or lameness<br>BCS: <br>Urogenital: external appearance normal<br>Temp: 20.7 kg</p><p>Differential diagnosis:<br>Rapidly growing ulcerative chest mass - possible secondary infection, neoplasia vs inflammatory process<br>Other masses - lipoma vs neoplasia</p><p>Laboratory:<br>Cytology - repeat indicated for ulcerative chest mass after Antibiotic course and on day of surgery due to inflammatory changes</p><p>Diagnostic imaging:</p><p>Treatment:<br>Antibiotics prescribed for 5 days pre-operatively to reduce inflammation and secondary infection in ulcerative mass</p><p>Plan:<br>- Start Antibiotics for minimum 2 days prior to surgery<br>- Schedule surgery Friday for lumpectomy of 2 masses (large ulcerative chest mass and fluctuating mass)<br>- Repeat cytology of ulcerative chest mass on day of surgery to confirm diagnosis and guide surgical approach<br>- Consider repeat cytology of small stable mass on day of surgery to determine if removal indicated<br>- Fast from morning of surgery<br>- Admit Friday morning, procedure same day</p>