C10028094 / invoice 10000

Reason: Lump Left Side Near Leg Very Red Appointment Notes: Overdue reminders seems fine otherwiseHistory:Presenting Concerns:-   Bob, a 5-year-old dog, presented for evaluation of a lump on his left shoulder. The owner noticed the lump this morning and reports it was more swollen and red earlier in the day. The area is still red, Bob hasn't been observed to be scratching the spot.  Diet/Appetite:-   Eating and drinking normally.  Skin & Coat:-   The owner reports that Bob sometimes scratches his ears.Examination:Mentation: BAR  Wt: —  BCS: --/9  T: Not taken  P: —  R: —  MM: pink/moist. CRT < 2sec.  Hydration: Normal    Emotional Assessment: Calm and cooperative for the examination. Readily accepted treats.    Eyes: Clear. No discharge or erythema OU.  Ears: Both ear canals are clean with no discharge, erythema, or debris noted on otoscopic examination.  Nose: Clear, moist without discharge.  Throat: No inducible cough upon tracheal palpation; no palpable masses.  Oral: Calculus and gingivitis absent. No masses or other lesions.  Cardiovascular: No murmurs or arrhythmias, strong synchronous pulses.  Respiratory: Normal bronchovesicular sounds bilaterally.  Abdominal: No organomegaly or mass effects. No pain on palpation.  Lymph Nodes: No peripheral lymphadenopathy.  Integumentary: A focal area of erythema and inflammation is present on the skin of the left leg. No discharge is noted. The nails are in good condition, though the dewclaws are slightly long.  Neurologic: No ataxia, normal mentation.  Musculoskeletal: Ambulation normal, no lameness observed.  Urogenital: Normal external anatomy.  Rectal: Not performed.    Point of Care Diagnostics:-   Otoscopic Examination: Both ear canals were examined and appeared clean with no debris or inflammation noted.AssessmentInflammatory skin lesion, left leg – DDx: insect bite, local trauma/abrasion, foreign body reaction, focal allergic reaction. The lesion appears to be a localized inflammatory response rather than a neoplastic growth. No signs of secondary infection, such as purulent discharge, were observed.PlanMedications/Treatments:-   Dispensed oral anti-inflammatory tablets. Give 3/4 of a tablet by mouth once daily for 3 days.-   It is crucial to administer this medication with or after a full meal to reduce the risk of gastrointestinal upset.-   The potential side effect of diarrhea was discussed. If this occurs, the owner was instructed to discontinue the medication and contact the clinic.  Additional Discussion:-   The owner was advised to monitor the lesion for improvement. The inflammation and redness are expected to resolve within the next 24-48 hours. If the lesion does not improve or worsens, a recheck examination is recommended.-   The clinic's new Saturday hours (8:00 AM to 12:00 PM) were discussed.    Vital Signs    Weight: 8.1;