C09973544 / invoice 60000

bandage change/ wound check

History: surgical wound medial L hock from Monday- bandaged for protection/dead space closure 
suspect infiltrative lipoma 

Clinical Exam: wound checks well- nil discharge, nil erythema 
weight bearing well 
no damage to the bandage


Plan:
could be left unbandaged- discussion with O- concern RE Blackie and Brownie licking the wound- elected to continue bandaging until suture removal ~10d
rpt bandage change on : Melolin (dry), wrapped with a buffer under the gastroc- VetWrap, Elastoplast. 
explained again- complicated LARGE histo case- expect results in the next 7-10d 



Pet insurance - Y
Is this a Gaponly Claim- Y

CH- Rebandage/assess wound
for GG

Patient Presented for:

History: 
has started licking bandaging in last 2-3 days
no e collar

otherwise well, bright and eating normally 

Clinical Exam: 
BAR
MM pink, CRT 1-2sec
BT 
LHL - distal end of bandage cutting into skin, with erythema and swelling of limb distal to bandage. bandage removed - purulent discharge distal half of wound, with rub wounds along proximal edge of bandage and distal edge of bandage 

definitive diagnosis: infection and cellulitis secondary to bandage complications/rub 

Plan:
bandage removed
flamazine applied
amoxyclav 500mg BID for 5 days 
carprieve - O already gave some at 2pm today, continue from tomorrow arvo 
given option of managing at home with e collar, separation from other dog, and applying cream, giving ABs. or keeping here in boarding for us to manage and monitor if this is difficult with other dog at home - electing to keep here to manage 
sutures due to be removed on Friday - hopefully will be suitable then can go home after this 

*still awaiting histo 


Pet insurance - Y/N
Is this a Gaponly Claim- Y/N

medical boarding - wound care

bright, wound looking better - still mild purulent discharge and moderate soft tissue swelling. no lameness
EDDU normal

clav and carprieve given, flamazine to wound 
e collar on 

called and updated O 
medical boarding - wound care

bright, EDDU normal 
wound looks ok, slow improvement but not yet strong enough to be candidate for s/r tomorrow - mild purulent exudate remains esp at distal end of wound 

clav and carprieve given, flamazine to wound 
e collar on 

called and updated O - advised GG will call next week when histo results have been returned to organise appt 
discussed keeping Blackie here over weekend - O feels this will be best as they are worried Brownie the other dog will lick at the wound even if Blackie can't  

handing over to MY for tomorrow
BES for weekend- have advised not to expect a phone call update unless something changes/you are worried 
once day vitals, meds morn + night.

Patient Presented for:

History: 
GG removed tumour on 16/02, sent for histopath- GG to communicate histo results w/ Os.
MY looking after Blackie today. Supposed to be discharged today however Os concerned other dogs will lick wound, would rather keep her boarded over weekend. 
BAR, EDDU normal. 

Clinical Exam: 
Limbs symmetrical, no swelling. No active oozing from wound today.
Checks well, TPR WNL. 

Plan:
> Wound cleaned w/ chlorhex at 2pm. 
> Amoxyclav BID, carprieve SID, flamazine BID
> Keep e-collar on
> MY to update Os this arvo, will notify not to expect phone call over weekend. 


BOARDING for wound management

AM 
- medicated, flamazine to wound
- CS to update o 

Owner updated Sat am - happy with how she is going, next update will be Monday unless concerned. CRS

PM update - BAR, wound looks good, meds given, flamazine applied. Eating well and happy.
Sunday boarding

Last dose amoxyclav this morning, flamazine applied, wound looks great. 
Eating, happy.