Northside Veterinary Clinic

April 28, 2017Revdex.com7007 Jefferson St. NE Ste AAlbuquerque, NM 87109ID: [redacted]To whom it may concern: I first met "Lexi," a seven-year-old Corgi mix female (spayed) dog, belonging to Ms. [redacted], on April 6, 2017. She was scheduled for a physical exam, heartworm...

check, and to discuss problems involving two of her feet; (1) her left front foot had a hard callus growth on her foot-pad causing her some pain, and (2) her toe on her right hind food had a sub-cutaneous mass which was also causing her discomfort and pain. I told Ms.[redacted] that these were both unusual growths and could be alleviated by surgical removal. She asked about the cost. I had read "Lexi's" record, which was faxed from her previous veterinarian, and knew she had this sub-cutaneous toe mass worked on twice before. My response was, "it's hard to say. I'll give you a ballpark estimate, but this is just an estimate, and I won't really know what it's all about until I go in and see what's actually going on." My initial exam and impression was that it felt like a Lipoma, also called a fatty tumor. Ms. [redacted] scheduled surgery for "Lexi" on April 17, 2017. On that day, Ms. [redacted] asked us to address a third problem; a bleeding, left, front dewclaw. After "Lexi" was anesthetized, I examined this dewclaw and saw a minor crack in the nail and an exposed "quick", the blood vessel of the nail cauterized this, and it was an easy problem to fix. I went to the second problem, the hard, callus growths (On her left, front foot-pad. Using a scalpel, I removed the wedge of abnormal tissue then sutured the good tissue to the other good tissue to close the gap. All went well, just what I had visualized initially on April 6, 2017.The last problem, unfortunately, turned out to be very difficult. After opening the skin over the entire lump on her right, hind foot, it was immediately obvious that it wasn't a typical lipoma, which has a fibrous envelope over the entire mass which holds it together as an entire mass, and, by blunt dissection from the surrounding tissues, can be carefully removed from its location. Instead what I encountered was a large fatty mass, which was adhering to all surrounding skin, tendons, muscle, bone, and blood vessels and which broke apart, due to fragility, as I tried to get it out of its pocket. I had to remove it piece by piece using small, curved forceps to break the adhesions from all the above. This was very delicate and time consuming. After removing the original mound, I then saw that it went deeper down to the bone, deep nerves, and blood vessels, where I saw a more solid core of the tissue surrounded by more of the fragile fatty tissue. I then had to carefully remove all of this as well. There was some bleeding, especially in the deeper areas of the pocket, and I had to control this by using electro-cautery and vetspon to promote clotting. After removing the excess skin and then suturing it all together, I decided to provide a pressure bandage to hold the newly sutured skin against the normal structure beneath, and to obliterate the large pocket that was keeping it from filling with blood and/or serum and to promote new adhesions of skin to tissues beneath. All of this took a while, and required a lot of care and concentration; a lot more than was anticipated with the original estimate. All together, we spent nearly three hours in surgery for "Lexi".I then went to lunch. When I returned to the clinic, Ms. [redacted] was also arriving and asked how "Lexi" was. I said she did great. Went inside and Anita, my great assistant, greeted Ms. [redacted] and started to explain all we had done while I took care of some business matters. Ms. [redacted] mentioned how concerned she was with the price, and I said it was much harder than I had originally thought. I then talked to her about limiting outside time for "Lexi" and no running; to go out with a collar and leash, to do "her business", and then back inside; to call if there is any severe pain; to use an E-collar if chewing on sutures; and to return in one week, to remove the pressure bandage. Ms. [redacted] made an appointment for the following week.The following day we received a phone call from [redacted] asking us to send a copy of our record for "Lexi". I thought something awful must have happened in the night. We were told they couldn't tell us unless they got permission from Ms. [redacted]; they said they would ask. We called back later and were told "she did not want them to tell us."I have thought about "Lexi" every day since, and I hope and pray that she is OK. I gave it my best!Sincerely,Dr. Stanley H[redacted]