C10017304 / invoice 10000

Reason:  lump on testicles. Noticed recently, also noticed lump on inner L inguinal region. Has had D+ for the last 5d. 
EDU NAD. 
Faeces is liquid brown, small frequent amounts, tenesmus. 
Current medications: fluoxetine. Did stop this for 5d and then restarted recently.
FTW not UTD. 
Sometimes fed small pieces of sausages- advised to stop this as this can cause D+/pancreatitis. 
No other recent change in diet. 

Examine: 
Mentation: BAR 
Wearing muzzle, outdoor consult, cannot assess thoroughly due to anxiety. 
Body condition score: 4.5/9
MM: -               CRT: -
HR: -               RR: -
LN: unable to feel well when awake
Temperature: UTT

Ocular: NAD
Oral/Dental stage: -
Ears: -
Cardiovascular: -
Respiratory: -
Gastrointestinal: NAD 
Integumentary & lumps (measurement, location): briefly felt a SC mobile mass 2-3cm in the medial/inner L thigh/inguinal region
Musculoskeletal: NAD
Urogenital: NAD
Neurological: NAD
Testicles: R testicle feels like it may have a mass on it, ~3cm or so- hard to differentiate when awake between larger epididymis/natural variation and neoplasia but does feel abnormal. especially if you feel between the testicles it does seem like a mass. 
Rectal: prostate is enlarged, does not seem overtly painful. There is a smooth round prostatic mass ~4cm diameter. 

Problem List:
1. Suspect R testicular mass. Advised castrate + histo. 
2. Enlarged prostate/prostatic mass, smooth round and non-painful. May be related to D+. Advised abd u/s + FNA if possible. 
3. L inner leg mass SC mobile- could not feel for long. Possible reactive LN, metastasis, lipoma, etc. Advised FNA/removal under GA. 
4. Large intestinal D+ the last 5d+. Could be related to testicular/prostatic issues/masses, vs underlying infection/inflammatory or other cause. Advised getting worming UTD (has at home), bland diet and start prokoalin. 

Some overall concerns with neoplasia. Needs to be castrated and when under GA can FNA (or remove) the inner L leg mass. Could do a thorough assessment of the prostate and abdomen/rectal/perianal region when under GA also. Abdominal u/s mainly for the prostate/signs of metastasis advised- could do on same day or separately from the castrate. 

Plan: 
As above. 

Message left for vets / nurses 05.03.2026 to confirm if we can dispense a sedative to be able to get Freddy into the clinic. Advised we will call back on the 05.03.2026 LB

Email received: 
Hi it’s Sean here, owner of Freddie McCann. I have just noticed what looks to be lumps on his testicles. There also appears to be a pretty big solid lump that appears in his groin area but isn’t ‘exposed’ constantly. Hard to explain but it’s not always showing
In just wondering if this is something urgent or not. If I need to come in he will need to be medicated like the previous times and I can’t remeber what meds we had him on 

I’ve attached a photo of the lumps on his testicles

Nurse initial: BM

Medication requested: Fluoxetine 

Any change in pets condition/symptoms: No

Current dose being given (note any differences): See hx

Any change in demeanour: No

EDUF, any changes: Y, no changes 

Vomiting/Diarrhoea: No

Collection date: TBC

Date of next revisit required: See hx

Any other concerns/questions: No