C10020921 / invoice 10000

Reason: 1 Week Post Op CheckIntern: RNOHistory:Shelby (9y FS Chihuahua) presented today for 1 week recheck post R 5th mammary gland mass removal (sx: 4/3/26)OR doing well, EDUD fine. Has been allowed time without E-collar and has licked at wound, mild erythema and discharge noted. Laboratory:HISTOLOGY ACCESSION No. VQ26-002940MACROSCOPICRight caudal nipple mass: The specimen consists of an elliptical excision of skin measuring 34 x 24 mm with fat extending 48 x 37 x 15 mm. There is a pink teat or nodule measuring 10 mm in diameter on the skin surface. Further sectioning shows a 6 mm lymph node peripherally. 1TS nodule 1A, 2 sections lymph node 1B. Cassettes require further fixation prior to processing.MICROSCOPICThree sections of haired skin and subcutaneous tissue are examined. Focally expanding the dermis and compressing the subjacent mammary glands is a densely cellular, unencapsulated, mildly infiltrative,fairly well-demarcated mass composed of nests and trabeculae of cuboidal epithelial cells, on a moderate fibrous stroma. Neoplastic cells exhibit mild pleomorphism with 1-2 small nucleoli, and the mitotic count is 15 per 10 consecutive high-powered fields (total field area 2.37 mm2).Two sections of subcutaneous lymph node exhibit moderate follicular hyperplasia and drainage reaction of primarily haemosiderophages with scattered eosinophils. There is no compelling evidence of metastatic neoplasia.DIAGNOSISCARCINOMA, SEE COMMENTMARGINSNeoplastic cells do not extend to the histologic margins in the examined sections. Minimum radial histologic margin 7 mm, minimum deep histologic margin 16 mm.COMMENTThis is an epithelial neoplasm-I favour a malignant neoplasm due to the peripheral invasion (albeit mild). In this location, the neoplasm is presumed to be of mammary origin and in this case the mitotic countgreater than 6 also indicates a malignant neoplasm, despite the only mild cell pleomorphism. Excision should be curative, however further staging of this patient could be considered if not already performed.Objective: Demeanour: BARTPR WNLMSK/Neuro = Comfortable. Walking around well. Good proprioception. Surgical site = Mild swelling and erythma around wound, very slightly exposed at distal aspect.Assessment: 1 week post-op R mammary gland mass removal - mild SSI/inflammation from licking at wound - antibiotics prescribedHistopathology returned low grade carcinoma, R0 margins, node negative - good prognosis. KOC will contact pathology to request grading. Plan:Cephalexin 100mg PO BIDCone on, no lickingRecommend staging by abdo US/chest radiographs in few weeks once recovered from surgery    Vital Signs    Weight: 4.2;       MMColour: pink;       Temperature: 38.6;       HeartRate: 140;       RespirationRate: pant;       CRT: 1 sec;       

Reason: Nipple Mass RemovalIntern: RNOHistory:Shelby is a 9yo FS Chihuahua presenting for a nipple mass removal. Mass is associated with the R 5th mammary glandR TWO on 18/12/25 for complete CrCL rupture and meniscal tear. Found nipple mass then, was thought to be bandage irritation as leukoplast was placed on it then.Was still present on 8 week post op RADs, had KOC look at it. Opted to remove mass and send it off for histopathology first prior to deciding next stepsPertinent medical history:R TWO on 18/12/25 for complete CrCL rupture and meniscal tearCurrent medications: NilExamination Findings: T: 37.8            MM: Pi P: 160            CRT: <2sR: 28Demeanour: BAR, anxiousWeight: 4.3 kgCardiovascular: Normal rate and rhythmRespiratory: Normal bronchovesicular soundsAbdomen: Comfortable, no abnormalities detectedPeripheral LNs: WNLsOcular: Normal,  Ears: NormalIntegument:- R 5th mammary gland mass meauring 8x8mmOral exam: NormalRectal: Not performedUrogenital: WNLMusculoskeletal: Ambulatory 4xNeurological: NADLaboratory: Idexx in-house CBC & Creatinine: WNLPCV/TP 50/72 clearSedated with methadone 0.2mg/kg IV, co-induced with ketamine 1mg/kg and alfaxalone to effect, maintained on isoflurane and oxygen.  Multi-parameter monitoring recorded throughout the anaesthetic.Surgery report:Date: 4/3/26Surgeon: KTLIntern: RNOThe patient was placed in dorsal recumbency. TAP Block was done with 2mg/kg bupivicaine. 4 corner draping was done to include the  mammary mass in the sterile zone. The 8x8mm mass that was associated with the 5th mammary gland mass was excised with proportional margins. SC and intradermal layers were closed with 3/0 monocryl in a simple continuous pattern. Sample was submitted to QML for histopathology.Recovery: Smooth, QAR, hypothermic. Bair hugger on. Treatment:IVFT hartmanns 3ml/kg/hr - d/c this afternoon if eating or drinkingMethadone 0.2mg/kg SC if req this afternoonMeloxicam 0.1mg/kg SC this afternoon, to continue oral tomorrowParacetamol 15mg/kg PO q8h PRN (children's panadol 100mg/ml = 0.65ml)Plan:Local anaesthestic block with bupivicaine was performed pre-opIVF @ maintenance, d/c this afternoon or if eating/drinkingMethadone 0.2mg/kg SC if req this afternoonMeloxicam 0.1mg/kg SC this afternoon, to continue oral tomorrowParacetamol 15mg/kg PO q8h PRN (children's panadol 100mg/ml = 0.65ml)    Vital Signs    

Reason: Nipple MassPet Primary Diagnosis/Suspected Diagnosis/Location: Lesion associated with nipple (5th mammary gland right side)Suspect cause: Unknown - trauma vs inflammatory vs neoplasiaAny other conditions being treated (if any): Recent surgery -R TWO on 18/12/25 for complete CrCL rupture and meniscal tearKnown health concerns: NilDate of first clinical signs (if known): Occurred within previous 8 weeks, has not resolved    Vital Signs