ZIGGY – A1034235

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ZIGGY – A1034235
**Perianal Hernia or mass that needs Vet attn!**

MALE, BLACK, POODLE STND, 7 yrs
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition EXAM REQ Intake Date 04/24/2015, From NY 11235, DueOut Date ,

Intact male, very matted coat – feels thin – flea negative, moderate dental tartar, slightly cloudy eye lens, clean eats, showed no signs of aggression during exam, QAR, NOSF
Weight: 14.2lbs

A shelter staff member writes: Easy to handle, friendly, upon intake

MEDICAL:
VC: PERIANAL MASS
LEFT PERIANAL HERNIA PRESENT, PAINFUL WHEN PALPATE, NO FECAL IMPACTION, SEMI FORMED STOOL IN RECTUM, DOES NOT NEED EVACUATION AT THIS TIME.
REST OF EXAM AS 4/27
P:
CONTACT NH AND SEEK PLACEMENT
NEEDS FULL PRE ANASTHETIC WORK UP AND PERIANAL HERNIA REPAIR AND NEUTER AT SAME TIME
POLYEHTYLENT GLYCOL 1 TSP DAILY AND MONITOR STOOL
WILL CONTINUE TO MONITOR AND EVACUATE RECTUM ONLY IF NEEDED.
CONTINUE TO MONITOR AND RC
FAIR PROGNOSIS AT THIS TIME

S/O: BAR, FRIENDLY
EENM: MM PINK AND MOIST, CRT 2 SEC, MODERATE GINGIVITIS AND CALCULI ESP PM AND M, BILATERAL OCULAR CLOUDING
CV: NO MURMURS OR ARRHYTHMIAS
LUNGS: CLEAR
ABD: SOFT AND NONTENDER, NO MASSES OR ORGANOMEGALLY
MS/INTEG: AMB X 4, BCS 3/9, APPROX 4 CM FLUCTULANT SOFT TISSUE MASS LEFT PERINEUM, NON PAINFUL, WARM TO TOUCH AND NON REDUCABLE WITH MILD PRESSURE, GENERALIZED AND DIFFUSE MATS
NS: APPROPRIATE
PLN: NSF
GU: IN TACT MALE, BOTH TESTES PALPATE WNL
A:
OCULAR CLOUDING: DDX CATARACTS VS OTHER
GINGIVITIS AND CALCULI
LEFT PERINEAL MASS: DDX HERNIA VS MASS (BENIGN/MALIGNANT)
P:
RECTAL EXAM +/- RADS IF NEEDED

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