C09973523 / invoice 10000

Appointment Reason: Recheck , Appointment Notes: recheck post arh - facial swelling/salivary mucocele - may be an admit if needed - will be fasted - SN O asked about desexing if needs G/A - told her we may not be able to do this, depends on how he is and what is needed/how our day is looking also. SN Appointment Reason: Recheck , Appointment Notes: recheck post arh - facial swelling/salivary mucocele - may be an admit if needed - will be fasted - SN O asked about desexing if needs G/A - told her we may not be able to do this, depends on how he is and what is needed/how our day is looking also. SN Dusky is a 3 year old entire male Bulldog that presented today with a right facial swelling.He was assessed by ARH on Saturday night and they could not find anything significant on examination and their report of FNA stated mildly neutrophilic fluid. No intracellular fluidPhysical examinationBARHR 104, normal heart sounds, marked stertorous breathing consistent with the breed.RR 28, MM pink, normal hydrationOral examination - grade 1Ears mild waxy discharge but no otitisEye examination normalSkin and coat normal - superfluous skin foldsAbdominal palpation normalMobility normalLymph nodes palpate - right SM area is enlargedAppetite and stools normalDiet: commercial and a few bits cooked at home, treatsHas been started on amoxyclav 500mg BID and meloxicam orally at home, both of which he had at homeOwner agreed to sedation and to explore the right facial area.Placed an IV cannula into the right cephalic vein.Administered metomide 10mg IV and 30mg omeprazole IVPreoxygenation prior to anaesthesia.Pre and intra-operative IV fluids administered at 5ml/kg/hActive warming.Premed: methadone0.8ml and 0.2ml medetomidine IV - great sedation achievedInduction propofol to effect.Maintenance Iso and O2 delivered via size 7.5 ETOral examination is unremarkable - no lacerations or penetrating wounds.No swelling noted sublinguallyNo nasal dischargeThe area of swelling would be consistent with parotid salivary gland, however cannot rule out a foreign body either.Brief examination with an ultrasound did not reveal a large cavitating lesion at present - solid soft tissue mass with a small pocketsFNA in house - using 22G needle found that the fluid to be haemopurulent with mucoid component.Cytology - marked neutrophilic component. Neutrophils are mature. No intracellular bacteria present.As owner showed me the photos of his face on the weekend - it has indeed improved.I have advised that CT with a view to surgery is still appropriate plan, but may be worthwhile waiting until a more organised abscess forms - if that is what it is.I have explained this to Hayley over the phone.Owner will book in an appointment on Wednesday for a review and see if surgery/CT /referral is appropriate at that point.Dusky has insurance - again, owner to find out what they are covered for.Treatment plan:- continue on amoxyclav and meloxicam for another 3 days    Vital Signs    Weight: 27.5;