C10019315 / invoice 10000

SCM:fasted o doesn't want dental rads or extractions, just scale and polish - said she will be contactable all day by phone if Derek has questionswants lump caudal dorsum removedno preGA exam done dt temperamenrt0.2ml meth/0.1mlACP sc at 8.30amDCW:Intubated with size 6.5 ET tubeFound two lumps on dorsum - one closer to right flank, with black hyperpigmented skin around it, and one cranial to that which was slightly larger but without hyperpigmented skin.Had a phone call with O to ask if she wanted that one to be taken off too, O accepted and said she was OK with it without an additional quote.Both lumps removed with 1.5cm margins with an elliptical incision (dorsal to ventral).  Both lumps appeared to be in the cutaneous layer only and did not penetrate into subcutaneous tissues.  Subcut layer closed with 3/0 PDS, simple continuous suture pattern.  Skin layer closed with intradermal suture pattern wtih 3/0 PDS.Some parts of the skin layer appeared to slightly evert, to an external suture was placed on those areas.Applied primapore above surgical siteDental was an uneventful scale and polish.  206 had ~3mm of attachment loss with a risk of future furcation > to watch at next dental.Post op 0.2ml meloxicam SC @11:30amHad a chat with O to double check if she wants to send off for histo - O declined for now, aware we keep the samples for a bit, but will throw it out eventuallyTGH w/ oral meloxicam 5kg SID w/ food 7d

O called up asking about dentals, + concerned with GA considering his ageAdv. her it should be quite safe, as we have blood tests results from ringwood vet octO works in healthcare field - wanted to know how it works for animals- Discussed premeds, intubation, isoflurane, etcForgot to tell O during call of pre-visit sedation - left a message- Gabapentin 100mg PO night before visit, + 90 mins before visit- Trazodone 50mg PO night before visit, + 90 mins before visit

due to the price changes since last estimate in may of 2024 the owner doesn't want to book in the procedure at the moment as it is more costly now and insurance isn't covering as much as last time.she said she will call once she has planned everything and will then book the procedure.ES