C10024106 / invoice 10000

Reason: Weak Pelvic LimbsHISTORY:Mimi presented for assessment following a sudden decline in condition. The owner reports that Mimi has been weak over the past week with associated loss of balance. Today, there was an acute deterioration. A brief triage examination, including an ultrasound, was performed upon presentation, which identified a liver mass with evidence of haemorrhage in the surrounding area. It is suspected that the clinical signs of weakness and collapse are secondary to blood loss from this mass.Specific History Questions:- Vomiting: Nil v+/r+- Mentation/Behaviour: Reported weakness and loss of balance over the last week, with an acute decline today.Pre-existing conditions:- A liver mass was previously diagnosed suspect hepatocellular carcinoma by Dr. Elizabeth in 2022. The decision was made at that time not to pursue surgical intervention due to Mimi's age.TriageHR: 84RR: 36Temp: 36.4Mm: pale pinkCrt: 1-2secMentation: QAREXAMINATION:Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Mentation appropriate. Full exam not performed.Musculoskeletal: ambulating normally x4, nil back/neck painGastrointestinal:- Oral: NSF, dental score 2/4)- Abdominal: A mass was identified on focused ultrasound, with evidence of associated haemoperitoneum.- Rectal: Not performedUrinary: nsfReproductive (incl ext genitalia): NSFIntegument/Ears: NSFLymph Nodes: WNL on palpationEyes: NSFPROBLEM LIST:- Suspected haemoperitoneum secondary to a bleeding liver mass- Weakness and collapseDIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Haemoperitoneum secondary to a bleeding hepatic neoplasm (primary differential). Less likely possibilities include benign mass rupture or coagulopathy.- Weakness/collapse: Secondary to hypovolaemia/anaemia from blood loss.DIAGNOSTICS:AFASTFindings are consistent with a bleeding hepatic mass. The extent of the mass and potential for metastasis could not be fully determined without advanced imaging.ASSESSMENT:Mimi, a 14-year-old dog, has presented with acute weakness and collapse. A focused ultrasound confirmed the presence of a previously diagnosed liver mass which now shows evidence of active or recent haemorrhage, resulting in haemoperitoneum. This is the most likely cause of her clinical signs. Given her age and the poor prognosis often associated with large, inoperable, or metastatic liver tumours, the options are limited. The two main options discussed were humane euthanasia or surgical intervention. PLAN:The owners have elected for humane euthanasia due to Mimi's advanced age, the high-risk nature of surgery, and the desire to prevent further suffering and a poor quality of life. The family will be given time to gather and say their goodbyes.CLIENT COMMUNICATION:A detailed discussion was held with Mimi's family regarding her condition. It was explained that the findings of a bleeding liver mass are very serious and are the cause of her weakness. The options of surgical intervention versus humane euthanasia were presented. Surgical options would involve a CT scan for staging, followed by a major operation. The prognosis even with surgery is guarded, as tumor could be not fully resectable or may have already metastasised. It was explained that without intervention, her condition will continue to deteriorate as blood loss continues, leading to increased suffering. The family understood the gravity of the situation and, after consideration of Mimi's age and previous decisions regarding the mass, elected to proceed with humane euthanasia. They were given private time in a room to allow all family members to be present.--- 11/03/2026 22:08:32 MWG:Owners elected PIP for Private Cremation. Lodged online. *OWNERS WOULD LIKE HER CREMATED WITH HER BED*--- 12/03/2026 09:15:50 EBR:TRANSFERRED INTO THE CARE OF PIP    Vital Signs