C09973719 / invoice 10000

Reason: Open Mouth BreathingHistory: 3pm noted that mouth was open and not interested in food at allLast ate yesterdya at 530pmEating less than usual in the last 4 daysIndoor/outdoor cat, history of CFA seen here. No current medications. No acess to toxinsPhysical Exam: Eyes: nadEars: nadCardiothoracic: subjectively, seemed to have effort. No abnormal lung sounds detected. Abdomen: no palpable painMsk: nadNeuro: nadSkin: nadOral cavity: misaligned bottom jaw, tooth protruding at an angle (not sure which tooth). Will not tolerate oral examinationRectum: nadUrogenital: nadPocus: no FAF noted on abdo US, no B lines noted, no shred signs noted. Assessment: Milo presents today with an open mouth configuration but without abnormal lung sounds. Given the misaligned bottom jaw, a jaw dislocation is highly suspicious; further evaluation under sedation is necessary with radiographs. Treatment: Given methadone initially @ 0.2mg/kg IM - 0.12ml TJ: given alfaxalone to effectRadiographs performed; no condylar luxation notedOral examination under sedation: somehow, 104 has pierced the dorsal rostral right lip.  Dislodged the tooth from its penetrative site.Disinfected with dilute chlorhxiedine, saline flush post.  Amoxyclav 15mg/kg - 1.4ml BID for 7 days Meloxicam 0.05mg/kg SID for a 5.5kg BW for 3 days.    Vital Signs    Weight: 5.92;       MMColour: pink and moist;       Temperature: 38.3;       HeartRate: 136;       BodyScore: 4;       DentalGrade: 2;       RespirationRate: 108, short shallow;       PainScore: 6/24;       BP: 113/68 82, tail size 2;       CRT: 1s;