C10019395 / invoice 20000

Appointment Notes: wants assesed some lumps that have popped up. AR 2/3  35kg todayHistory: Presenting for : lumps check EDUF: normal V/D/C/S: none Father of dog died at 8yo due to cancer, therefore O is very wary of any lumps Noticed new lump on L middle thorax recently, O said is most prominent from lying down but has had difficulty finding it when Bronzi is standing Examination: Mentation: BAR 	BCS: 5/9	Temp: ntMM: not assessed	CRT: 1-2s 	LN: subman, prescap, poplit WNL EENO: nad. Mouth shy - unable to assess oral cavity. CVS: no murmurs or arrhythmias on auscultation. HR = 100Resp: no adventitious lung sounds on auscultation. RR = panting GI: comfortable on abdominal palpation, no focal areas of repeatable pain Integ: 1-2 cm SC firm mobile lump on L middle thorax - most prominent when dog is lying down, difficult to find in consult. 1cm SC firm mobile lump to the L of sternum (FNA'd) - O had not previously noticed this lump. 2cm firm mobile lump in L flank. MSK: nadAssessment: Clinically well Multiple subcutaneous small lumps - firm and mobile in character. FNA of lump near sternum showed fatty cells - most likely lipoma Plan:Due to difficulty assessing the other lumps due to patients demeanour (unable to be still), O will return with chill pills on board for further FNA investigation of lumps - also advised owner to mark where lumps are on the body due to difficulty finding in consult. - Chill pills dispensed and to revisit later today FNA results from sternal lump shows most likely lipoma - advised O it is likely a benign fatty lump which is common in dogs as they age, may gradually grow. Re-visit if appearance of lump changes quickly or if the size of the lump starts to impede on mobility.    Vital Signs    Weight: 35;       

Appointment Notes: cytology on extra lumps - ash35.1kg'Came back from this mornings appointment with chill pills on board. Good level of sedation, definitely more calm but not too sedate. FNA of thoracic lump - obtains only a very small number of cells, all looked normal. Told O to keep an eye on the lump since it is only very small at the moment- look for any changes in size or appearance and revisit if any concerns. FNA of flank lump - fatty cells, most likely lipoma    Vital Signs