C10031463 / invoice 10000

Revisit reason:
History:
Surgery 9 d ago
HAs been able to lick, managed to bend rigid collar, inflatable is a bit easier & O said has been a bit less licking past few days

Medications: carp finished today
EDUF: all fine
Mentation: bar
BCS (0-5):      3

RR: 20
MM:    p,m              
CRT: <1
Temperature: ne

Any additional findings:
moderate erythema & swelling aorund surgical site, incison mild greenish discharge & not fully apposed

Assessment:
infected wound

Treatment:
carp 75mg bid
clav 500mg bid
gaba 1200mg bid

recommend shirt or draw string soccer style shorts
also adv longer term consider bromelli sunsuit - sent O link


On-going medications required: Y/N (use prescription tab for further supply):

Plan: rv in 1 wk
O can send picture if feels getting worse, next po check in 1 wks time

Discussed results with o. They have an appointment tomorrow to check the wound as Milo has been licking at the site.

Histopathology Results:
Left prepuce mass: Cutaneous haemangiosarcoma with concurrent actinic dermatitis

Mitotic count (per 2.37 sq mm): 2
Histologic margins:  clear  ; the nearest peripheral margin is   2.3  mm, with   1.3  mm deep

COMMENTS:
The microscopic appearance of the mass is consistent with an infiltrative cutaneous haemangiosarcoma
with evidence of solar-induced changes in the adjacent epidermis. Dermal and conjunctival
haemangiosarcomas may be due to chronic solar irradiation ('sun-baking'), with increased risk in
whippets and other short haired lightly pigmented breeds. Solar induced ( actinic ) lesions are often
multiple, may be infiltrative and may recur following incomplete excision. Occurrence on the thinly
haired skin of the ventral abdomen and inguinal region is common. The cutaneous actinic type tends to
be less aggressive than visceral haemangiosarcoma with a lower probability of metastasis and longer
survival following complete excision. Additionally, regular clinical monitoring for solar-induced
lesions is warranted, as this individual may be at increased risk for additional sun-induced
preneoplastic and neoplastic lesions

Reason: Courtesy phone call post surgery/ procedure
Nurse: JW

TTCONALM & SMS sent - follow up after procedure yesterday