C09975549 / invoice 10000

History:Admitted for chin swelling sedate and explore.HR 240RR 36Temp 39.7Pre-anaesthetic bloods: - mild anaemia (low normal HCT with normal RBCs) - inflammatory leukogram - possible low platelets, adequate for haemostasisAlready sedated with 0.2mg/kg methadone and 0.04ml medetomidine IM to facilitate blood collection.Topped up with further 0.1mg/kg methadone and 0.04ml medetomidine IV via 25g catheter placed R cephalic.Procedure:Maintenance: alfaxan aliquots of 0.2ml IV as requiredPeriop IVFT: 3ml/kg/hr hartmanns throughoutMonitoring: SPo2, NIBP, manual TPRULcerated gingiva in the buccal cavity of 309 and 409 adjacent to tooth - query whether from trauma from 108/208, or reaction to plaque?Gingivitis and heavy tartar on 108/109.Halitosis.Large, firm swelling along ventral/lateral mandible of 407-409, palpable externally, and also in the buccal cavity.Small amount of purulent discharge into the mouth from ulceration adjacent to 409 when pressure applied. No periodontal pocketing.However, dental probe aimed ventrally through the ulcerated area goes deep into the mandibular swelling, palpable externally.Dental radiographs taken:- both sides similar - no tooth root abscess, no bone loss (area of mandibular bone over 308/309 and 408/409 looks more lucent that other areas, but with no probing deficits or mobility query normal?)- soft tissue swelling only, no bony abnormalitiesCytology (FNA swelling): RBCs and neutrophils (wtih bacteria) onlyStab incision over swelling ventral mandible; connection to ulceration in the mouth.Copious flushing with sterile saline.No FB found. No large pocket of pus, swelling continues to feel firm.Cleaned with iodine.Intra-operative events: Nil - very painful over ulcerated areaMedications: 0.1mg/kg meloxicam SC upon recvoery.Recovery: Smooth. Discharge:Home with e-collar.Post-op meds: - Starting tonight (if eating) - 1.0ml noroclav PO BID with food- starting tomorrow night - 4kg meloxicam dose PO SID with food.Soft food.Discussed will likely need dental with extraction of 108/208 if continuing to traumatise (and reassess the lower carnassials) - plan for this...--- 02/03/2026 18:04:50 EC:  Rhinotracheitis, Calicivirus & Panleukopenia vaccination - Skipped on 02/03/2026    Vital Signs    Weight: 4.18;