C10019221 / invoice 20000

Reason: Check New Lump Near VulvaAppointment Notes: wants to have sampled as is booked in for other MCT removal on 20/3. Normally sees LS, knowns she is unavailable. eaSubjective and history: New lump seen on vulva present for a month or so (comes and goes) Scoots occasionallyObjective: RHS dorsal to vulva (between anus and vulva on fatty tissue on RHS) is an approx 1cm x 1cm x 0.2cm pink, hairless well circumscribed mass On vulva distal margin in a 3mm nodular massRectal exam: L ag full, R emptyLaboratory: RHS dorsal to vulva mass: Uniform mast cells ++3mm nodular mass on vulva-> sparse cocci, rbcs. No other cellsAssessment: Additional MCT on RHS dorsal to vulvaPlan: Masses to remove next Fri:1) MCT LHS ventrolateral thorax towards last rib (approx 5mm x 5mm x 2mm pink mass)2) MCT RHS dorsal to vulva (approx 1cm x 1cm x 0.2cm pink mass)3) Ventral thorax approx 1cm x 2cm pendulous skin tag    Vital Signs    

Reason: Ear InfectionAppointment Notes: Storm Martins de La Casa (Dog) - Thais Martins - 0452193761 - Consultation Standard (one concern and rechecks) [Clinician : Dr. Louise Schaffer (Preferred Clinician)] - ear infection  - friend Web BookingClient name: Thais MartinsContact number: 0452193761Email address: thais-martins-0123@hotmail.comPatient name: Storm Martins de La CasaSubjective and history: 23/02- neptra applied L ear (yeast) - 2 weeks agoGoing wellLess inflamed and redWill book in MCT and skin tag removal soon Objective: BARL ear much less inflamed cf prev- mod vol yellow ceruminous dischargeR ear mild debrisLaboratory:  Ear cytology: L ear: yeast + (2 POIF), R ear: clear Treatment: 1. Neptra 1 ml AS Plan: O will schedule MCT sx + skin tag- would like a Friday so will be w FM- O aware    Vital Signs    Weight: 37.9;       

Vet O Clinical summary/referral attached.LS re-read notes, MCT report still not attached MCT surgery and histopathology report needed. Esp histo pls--- 27/02/2026 13:14:38 GR> spoke to receptionist, will call me back, looking for report from vetnostics from histopatology from MCT sxLaboratory: 3/12/24    MICROSCOPIC Epidermis is focally elevated and the underlying dermis is infiltrated by a sheeted population of neoplastic mast cells forming a nodular unencapsulated mass they are distributed amongst existing and thickened collagen, oedema, mucin as well as eosinophils. Cells have uniform and well-differentiated features, karyomegaly is minimal and there is no multinucleation. The mitotic count is less than 1 (2.37mm2). The minimum histologic tumour free lateral margin is more than 5 mm and the deep margin is more than 5 mm.    DIAGNOSIS Mast cell tumour, Patnaik grade 1, Kiupel low-grade    COMMENT/S There were no neoplastic mast cells at histologic margins. MCT grading systems have prognostic significance. Grade 1/low-grade. The prognosis is excellent with virtually no tumour-related deaths. One study reports a low risk of lymph node metastasis (6%) and distant metastases (2%) at initial staging. Grade 2/low-grade. The prognosis is supposedly good with 3% to 17Client Communication: --- 03/03/2026 10:17:51 LS: STO- discussed prev results. Discussed can send cytology to vetnostics for confirmation of likely MCT if O would like, otherwise recc proceed to sx to assess grading, remove skin tag at same time. If Storm develops multiple grade 1 MCTs option to remove with reduced margins + consider onco consult to discuss ongoing managementO at airport, will book in for sx when back    Vital Signs