C09970365 / invoice 10000

Reason: Bandage Change, Mars PatientHISTORY:Presented for bandage change on the right hind leg. Booked for wound reassessment and re-bandaging with MARS tomorrow.Current meds: Meloxicam, Paracetamol, Amoxycillin/clavulanic acid (started 23/02/2026), Gabapentin, Enrofloxacin (started 27/02/2026).Prophylaxis: Up to date.Pre-existing conditions:18/02/2026: Excision of five skin masses.  - 1: Lateral aspect of hock at the level of the proximal metatarsals (approx 2-3 x 2-3cm). Cytology inconclusive. Distal end left open for second intention healing.  - 2: Lateral aspect at the level of the distal tibia and achilles (approx 2-3 x 2-3cm). Cytology suggestive of soft tissue sarcoma.  - 3: Right lateral thorax (0.5 x 0.5cm).  - 4: Left lateral thorax (0.5 x 0.5cm).  - 5: Ventral neck (0.5 x 0.5cm).Masses submitted for histopathology.23/02/2026: Recheck for right pelvic limb oedema and skin necrosis. Wound swab taken for C&S.25/02/2026: Sedated bandage change.26/02/2026 & 27/02/2026: Bandage changes.28/02/2026: Bandage change. C&S results showed resistance to amoxyclav, enrofloxacin started on 27/02/2026.Triage:HR: 120RR: 20Temp: 38.2Mm: pink and moistCrt: <2Mentation: BAREXAMINATION:Body Condition Score: 6/9Pain Scale (0-4): 1/4Hydration status (%): EuhydratedCardiovascular: cardiac ausculation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Mentation appropriate. Plr positive , menace positive, palpebral positive . No abnormal strabismus or nystagmus positional or otherwise noted. Normal facial sensation and motor. Normal facial symmetry. Normal gag reflex. No neck pain. CPs and withdrawals present in all limbs. Patella reflexes intact. Cutaneous trunci reflex WNL. Strongly ambulating with no observable ataxia. Normal posture. Perineal reflex WNL. Adequate anal tone. Full exam not performedMusculoskeletal: Strongly ambulating x4. Adequate range of motion in joints, no overt swelling or painGastrointestinal:Oral: dental score 1/4Abdominal: Abdomen soft, non painful on palpation. No organomegaly or fluid wave appreciatedRectal: not performedUrinary: no significant findingsReproductive (incl ext genitalia): no significant findingsIntegument/Ears:Proximal wound on right hind limb well-opposed with sutures and healing well.Distal portion of the wound has a 1x2 cm area of exposed granulation tissue with surrounding tissue necrosis.Proximal limb oedema present.Lymph Nodes: peripheral lymph nodes palpable < 1cmEyes: no significant findingsPROBLEM LIST:Post-operative wound on right hind limb requiring ongoing management.Surgical site infection (SSI).Tissue necrosis and oedema of right hind limb.DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Right hind leg soft tissue sarcoma resection requiring rebandaging.DIAGNOSTICS:C&S results from 25/02/2026:Org 1: Leclercia adecarboxylataOrg 2: Pasteurella canisBoth resistant to amoxyclav.ASSESSMENT:Presents for a re-bandaging of the surgical sites on the right hind limb. The proximal wound is healing well. The distal open wound has some surrounding tissue necrosis and proximal limb oedema. The bandage was changed without sedation.TREATMENT:The previous bandage was removed. Wounds were cleaned with dilute chlorhexidine. Re-bandaged with an Allevyn dressing on the surgical sites, followed by Soffban, conforming bandage, and Vet-wrap. An Elastoplast dressing was applied proximally to prevent slippage. Soffban padding was applied between the toes to prevent pressure sores.PLAN:Discharge into owner's care.Represent to MARS tomorrow for booked consult for wound reassessment and re-bandaging.CLIENT COMMUNICATION:Discussed the current state of the wound and the plan for ongoing care. Instructed to continue with home care and to attend the scheduled recheck appointment with MARS tomorrow.    Vital Signs