C10017518 / invoice 10000

Reason: Scratched Possible Lump Raw On NeckAppointment Notes: scHistory: Scratching, flicking his head/ ears. Swollen neck area. Been annoying him a lot. Noticed scratching first, then swelling. Owner has given some flea treatment too. Scratched himself red raw under neck. Noticed on monday. No energy. Still eating ok but not massively. Have eaten biscuits Is hiding all the time. No v/d/s/c.Examine: BAR, vitals wnlLeft submandibular lymph node is equivocally enlarged; rest of peripheral lymph nodes ok upon palpation. Auscultation & abdominal palpation wnl. Scoped both ears- minimal inflammation, virtually no discharge, no obvious fb; tpm appear intact. Left ventrolateral neck near jugular groove area there is a focal alopecic erythemic thickened/ inflamed patch with mild erythema adj skin area. Slightly uncomfortable upon clipping otherwise not overtly painful. Rest of skin/ coat appears wnl. Eat treats eagerly in consult otherwise. Laboratory: impression smear- 90% neutrophils, 10% macrophages, cocci in pairs (staph?) Assessment: looking like a pyoderma / hot spot type of dermatitis. Treat symptomatically. Revisit in 2 weeks for reassessment. Treatment: clipped & cleaned area with dilute betadine in consult Cephalexin 750mg (= 23.9mg/kg) po bid x 14 days Neocort on affected lesion bid Plan: revisit in 14 days- reassess likely hotspot lesion on left ventrolateral neck area- decide whether to extend abx course or proceed with ga biopsy & c/s (est provided today)    Vital Signs    Weight: 31.4;       MMColour: pink ;       Temperature: 39.0;       HeartRate: 126;       BodyScore: 4/9;       RespirationRate: panting ;