C10016905 / invoice 20000

Species:CANINE
Breed:Maremma Sheepdog
Age (years):8
Diagnosis or signs:Abscess + surgery
Consult notes
11/03/2026 Hx/ noticed swelling under Rocky's neck the last couple of days. Is otherwise well - DUDE normally, no v/d/c. Not pawing at it or seeming bothered by the area.
No other swellings noted.
Does live on property/spends a lot of time outside

Cx/ MM pink and moist, crt <2s
Dental - 2/4
Back of mouth NSF
RR panting - normal ausc
HR - 112, no murmur or arrhythmia, pulses sync and strong
Skin - large swelling ventral neck/laryngeal area - soft and fluid filled but firm in some areas. Cannot feel R side LNs due to the swelling but L side LNs feel normal. Not painful to palpate. 
LNs - otherwise normal 

FNA of the swelling - frank pus (confirm on microsope > RBCs, Neuts, other WBCs)

Ax/ large abscess ventral neck
ddx: FB (grass seed) vs infected growth

Px/ advised given location - could consider referral for CT to ensure no underlying growths or FB stuck deep in tissues OR could do simple GA and incise/drain initial abscess and flush / try to locate a FB, then leave it open and do course of NSAIDs/ABs. If resolves - great, if not and swelling persists/recurs - then CT imaging may be required.
Keen to try second option > called NC - have time to do today so send straight there.

No premed etc. given
Has had breakky early this morning and had 1x chicken treat in consult.

11/03/2026 Methadone 10mg/ml (Methone) Injection 20 ml - CSD 3:15

11/03/2026 2 Acepromazine 2mg/ml Injection - CSD 3:15

11/03/2026 Objective: Abscess
Pre-op exam: see Smartflow (or enter ~tprx for macro)

Systems:
1. Eyes: NAD
2. Ears: NAD
3. Mouth: NAD
4. Heart: NAD
5. Respiratory/Nasal: NAD
6: Abdomen: NAD
7. Musculoskeletal: NAD
8. Neuro: NAD
9. Urogenital: NAD
10. Rectal/Anal glands:not examined
11. Skin: large fluid filled swelling ventral neck
12. BT: normal
13: Behaviour issues:no
14: Lymph nodes:NAD
15: Dental Score: 2/4
16: Body Condition Score: 3.5/5
17. Other findings:{__}

Preanaesthetic blood screen: abnormalities
mild decrease reticulocyte-haemoglobin --> bleeding into suspected abscess
Monocytosis --> inflammation 

Anesthetic records: see Smartflow (or enter ~anex  for macro)
Premedicated with 0.3mg/kg methadone & 0.02mg/kg ACP SQ. Good level of sedation. Intubated with size 11 cuffed ETT. 

Dysphoria on recovery. Given 0.15ml medetomidine IV. 

Surgery:
Lanced abscess and flushed with sterile saline. Derided necrotic tissue. Not much exudate procedure. Could palpate what felt like jugular vein with finger. 
Penrose drain placed and secured in place with 2-0 monosyn. 
Post-op analgesia and antibiotics  given(see Smartflow)
Additional drugs required - Home with carprofen bid & amoxicillin BID
Revisit in 3 - 5 days for drain removal.  Sutures to be removed in 10 - 14 days.

Recovery physical exam : see Smartflow (or enter ~tprx for macro)

11/03/2026 Alfaxalone Inj 10mg/ml - 0.5 ml given iv CSD

Animal clinical history (3 most recent)

2026-03-11T00:00:00Z 13:03:26
Hx/ noticed swelling under Rocky's neck the last couple of days. Is otherwise well - DUDE normally, no v/d/c. Not pawing at it or seeming bothered by the area.
No other swellings noted.
Does live on property/spends a lot of time outside

Cx/ MM pink and moist, crt <2s
Dental - 2/4
Back of mouth NSF
RR panting - normal ausc
HR - 112, no murmur or arrhythmia, pulses sync and strong
Skin - large swelling ventral neck/laryngeal area - soft and fluid filled but firm in some areas. Cannot feel R side LNs due to the swelling but L side LNs feel normal. Not painful to palpate. 
LNs - otherwise normal 

FNA of the swelling - frank pus (confirm on microsope > RBCs, Neuts, other WBCs)

Ax/ large abscess ventral neck
ddx: FB (grass seed) vs infected growth

Px/ advised given location - could consider referral for CT to ensure no underlying growths or FB stuck deep in tissues OR could do simple GA and incise/drain initial abscess and flush / try to locate a FB, then leave it open and do course of NSAIDs/ABs. If resolves - great, if not and swelling persists/recurs - then CT imaging may be required.
Keen to try second option > called NC - have time to do today so send straight there.

No premed etc. given
Has had breakky early this morning and had 1x chicken treat in consult.

Previous claim history (3)

DateClaim #Diagnosis
2026-01-15C09765695MASS LESION - SKIN (CUTANEOUS)
2025-10-09C9344252MASS LESION - SKIN (CUTANEOUS)
2025-10-08C9321617MASS LESION - SKIN (CUTANEOUS)

Line items(lines with upstream diagnosis are skipped by the model)

LinetstarcAmountDateUpstream diagnosis
10000tstarc_anaesthesia_-_inhalation_anaesthetic399.302026-03-11
20000tstarc_procedure_fee127.602026-03-11
30000tstarc_antibiotics_-_amoxicillin35.492026-03-11
40000tstarc_carprofen34.902026-03-11
50000tstarc_diagnostic_test_-_electrolytes39.602026-03-11
60000tstarc_diagnostic_test_-_haematology62.702026-03-11
70000tstarc_disposables53.902026-03-11
80000tstarc_diagnostic_test_-_biochemistry134.202026-03-11
90000tstarc_meloxicam36.462026-03-11
100000tstarc_penrose_drain12.102026-03-11

UPM+

  • DG00005ABSCESSDSTP_abscess_-_unspecified

Variant (sleepy_king)

ABSCESS
DSTP_abscess_-_unspecified
Conf: 0.640
Threshold: 0.53
Above:
Correct?