C09970440 / invoice 20000

Reason: sore between toesHistory:Licking at swelling between RF footHas had this previously and was explored at regular vet; couldn't find anythingWent away on abx and nsaidsHas just returned and licking at lot at itSubjective: BARObjective: HR/PR/CV: 100MM/CRT/Hydration: pink, moistRESP/RR: regularTemp: 38.7Skin/Ears: interdigital swelling between RF digit 2-3, no sinus seen but can see scar from previous explore incisionAssessment: Recurrent interdigital swelling ddx: remnant g/s vs interdigitial furunculosis>recc re-explore but possibility of still not finding anything vs meds and monitor; opted repeat explorePlan: Admit for re-explore; if negative then meds and consider CT if ongoing issues    Vital Signs    Weight: 10;       

Reason: Paw explore Objective: see previous entry Status: 2Treatment: Premed 0.3ml methadone + 0.05ml medetomidine IM @1:22pm Induction 1.5ml alfaxan IV @1:42pmIntubated with size 4.5 cuffed ET tube and maintained iso 2%/oxygen 0.8L/minEars: mild wax Teeth: G2 Nails: trimmedSurgery started 1:45pmTechnique: using pink needle created hole in swelling, probed with alligator forceps no FB detected, converted to sx explore. Incised over swelling, probed with alligator forceps. Sinus extends ventrally, no FB found. Closed with 3/0 silver glide simple interrupted in subcut, cruciate mattress in skinBandage: melolin over wound, cotton wool between digits, sofban elastoplast Surgery finished 2:20pm Anaesthesia finished 2:20pm Recovery smooth Pain relief meloxicam 0.3ml sc @2:25pm meloxicam 8kg dose Po SDI to start tomorrow amoxy clav 125mg Po BID Plan: F/U call tomorrow.b/c in 2-3 days INI or worsens rec'd CT to try and locate suspected FB     Vital Signs