C10030893 / invoice 10000

Reason: Npc - Lump On Left Side (MM)Appointment Notes: Zelda (Dog) - Recheck Appointment (current issue) [Veterinarian : Dr Rachele Lowe(No Preference)] - Lump on left sideWeb BookingClient name: Annelise ArnesenContact number: 0416389761Email address: annelisearnesen@gmail.comPatient name: ZeldaHistory:Presenting for: Zelda, a 5-year-old female dog, presented for re-evaluation of a left axillary mass that has grown significantly since initial assessment by Amy, who performed fine needle aspiration showing likely fat/lipoma, with mass now considerably larger than the original 2cm x 2cm size.Historical Conditions:- Previous desexing surgery- Previous cruciate repair surgery with screw and plate placement in left leg - recovered well with no ongoing issues- Fine needle aspiration of current mass previously performed by Amy showing fat cells consistent with lipomaSkin:- Current skin issues with increased flare-up due to recent moisture and humidity- History of allergic skin disease - prone due to colour dilution gene- Previous response to Cytopoint injectionsCurrent Meds:- Previous Cytopoint treatment (not recent)Examination:Mentation: BARIntegumentary:- Left axillary mass significantly larger than previously recorded 2cm x 2cm, now approximately 3-4cm, mobile, palpable from behind when walking- Skin showing signs of allergic dermatitis, particularly affecting feet with some licking behaviour notedAssessment:Left axillary lipoma - rapid growth since previous assessment. Despite benign cytology, surgical removal recommended due to significant size increase, awkward location potentially affecting gait, and proximity to axillary nerves and vessels. Histopathology may be warranted given breed predisposition to mast cell tumours, though patient age and previous cytology findings suggest lipoma most likely.Allergic dermatitis - flare-up associated with recent humid conditions, affecting feet primarily with secondary licking behaviour.Plan:Medications/Treatments:- Surgical removal of left axillary mass scheduled for Wednesday 1st April, admission at 07:30, with potential histopathology depending on gross appearance at surgery- Pre-operative fasting required - no food after 20:00 the night before, water allowed until admission- Post-operative care will include pain relief injection at approximately 12:30, discharge typically after 15:00-16:00 same day- Post-operative protective collar or bodysuit may be required depending on patient behaviourNew Meds/Tx:- Flamazine cream $85 - apply BID for one week to affected skin areas, ensure 10+ minutes contact time before allowing lickingAdditional Discussion:- Surgery scheduled for Wednesday rather than Thursday to allow normal clinic hours the following day for any post-operative concerns- Cytopoint injection discussed as alternative treatment for skin condition but deferred until after mass removal due to recommendation against immunomodulatory treatments when growths present- Pyoderm Lemone conditioner mentioned as potential future treatment option for feet- Post-operative period may require 2-3 weeks recovery with protective measuresClient Comms:- Surgical procedure explained including day surgery protocol with morning admission and afternoon discharge- Post-operative care instructions provided including fasting requirements and admission timing- Cost estimate provided: Flamazine cream $85, Cytopoint $230 if needed post-surgery- Follow-up call will be made post-surgery to arrange discharge time    Vital Signs    Weight: 17.3;