C09973089 / invoice 10000

Preanaesthetic physical exam unremarkable, bloods - unremarkablePremed 3mcg/kg medetomidine IM0.4mg/kg Methadone IM Anaesthetic: Induction - Alfaxan to effect. Maintenance - Isofluorane. Monitored SPO2, vital signs and blood pressure. No anaesthetic complicationsH/e blood pressure low normal throughout - managed with 1.5x boluses hartmanns + 2 doses of atoprine (HR was around 100 at both times) this kept BPs in safe range. Missing teeth: see chartUpper right molars - moderate gingival recession Moderate teeth chattering with scaling and probing h/e probing WNL and rads WNL Moderate tartar, no  gingival recession. No furcations visible or significant pocketing.All teeth scaled and polished. Gingival suculus probed. No x-rays taken.Ulcerated mass over caudal dorsal rump approx 0.7cm x 0.7cmElliptical incision - two subcut sutures to close dead space. Intradermal 3/0 monosyn.Plan:Recheck in 5-10 days, sooner if any concernsTemg 0.3ml PO BID 3 days    Vital Signs    Weight: 999;       

To the Practice Manager, Regarding the pre-approval request for Zippy (Est for lump removal + dental). Pet’s Name:  ZippyDOB:    08/04/2010Customer Name: Nicola WrightCustomer Address: U 16 78a Old Pittwater Rd BROOKVALE NSW 2100 The expected gap amount to be paid by the client (based on the estimate submitted) is: $517.10. Please note that the gap amount is an estimate and may vary from the pre-approval if the benefit amounts available under the policy change before the claim is submitted or if the finalised invoice for the treatment submitted differs from the estimate previously supplied. We reserve our rights to apply the applicable pet insurance policy terms and conditions to the claim in the event that further relevant information becomes available.  The policyholder has been provided with a letter regarding this pre-approval outcome. Should the policyholder require further information, the details for contacting us have been provided to them in that letter. Thank you. Yours sincerely,JuvyTo the Practice Manager, Regarding the pre-approval request for Zippy (Estimate for histopathology). Pet’s Name:  ZippyDOB:    08/04/2010Customer Name: Nicola WrightCustomer Address: U 16 78a Old Pittwater Rd BROOKVALE NSW 2100 The expected gap amount to be paid by the client (based on the estimate submitted) is: $74.84. Please note that the gap amount is an estimate and may vary from the pre-approval if the benefit amounts available under the policy change before the claim is submitted or if the finalised invoice for the treatment submitted differs from the estimate previously supplied. We reserve our rights to apply the applicable pet insurance policy terms and conditions to the claim in the event that further relevant information becomes available.  The policyholder has been provided with a letter regarding this pre-approval outcome. Should the policyholder require further information, the details for contacting us have been provided to them in that letter. Thank you. Yours sincerely,Juvy    Vital Signs    

Reason: Check Up, Talk About Operation, Update QuoteAppointment Notes: khHistory: Thyroxine - haven't tried it. Energy levels okAppetite okNo further diarrhoea or soft stool Physical Exam: Moderate tartar and severe gingival recession in places. HR 220, no murmurCystic lump, ulcerated skin over rump approx 2cm x 1cm Plan: O happy with demeaour, appetite, weight at home therefore no desire to trial thyroxineProceed with lump removal surgery and also clean teeth at the same time. Some extractions may be required    Vital Signs    Weight: 6.08;