C09977198 / invoice 10000

Reason: S/o W/ A Vet TBAppointment Notes: Overdue remindersAttendees:History:Rudy presents for removal of sutures at site of RHS aural haematoma. O reports minimal discharge from ear and appears comfortable. Recovered from anaesthetic uneventfully not concerned by suture lineEating drinking urinating defaecating normallyNo vomiting/retchingNo coughing, no exercise intolerance, no breathing difficultyNo lameness, stiffness or sorenessNo itching and scratchingBright Alert ResponsiveBody condition score 7/9 Examination:Mucous membranes – pink moist crt <2sOral cavity – clear, no evidence of ulceration, tongue normal, hard palate fineTeeth – grade 0Nasal planum – normal pigmentation and architecture, no crusting, no dischargeEyes – eyelid conformation normal, PLR normal, no chemosis,  no dischargeEars – RHS sutures removed, moderate inflammation with serosanguinous exudate (pyogranulomatous with intracellular cocci) and ulcerative lesions at site of suture bed. Cytology from canal scant populations of malassezia. Lymph nodes - normalHeart – normal regular rythymn no pulse deficits, no murmurLungs – clear sounds bilaterally, no crackles or wheeze, tracheal pinch negativeAbdomen – comfortable on palpation, bladder normal, no masses palpatedLimbs – all good range of movement, no swelling or pain on palpationNeck and spine – no pain on palpationSkin – no sign of erythema, no alopecia,  suture line fine no reactionNails – fineAnal glands – not scootingTemperature – not takenGenital region - no masses or swellingsSedation: Required to remove sutures. 0.8ml medetomidine & 0.32ml butorphanol IM to good effectreversed with 0.8ml antisedan imAmoxyclav 500mg BID PO for 7-days to address infection of external pinnae. Complete course of dermotic as precribed. Re-check in 7-days if any concerns.--- 03/03/2026 09:57:10 KI:Surgery Follow Up - Resolved - Telephoned and owner not available.- Left voice message to call us back- SMS sent for O to follow up    Vital Signs    

Reason: A/h Sx KjAppointment Notes: Overdue remindersDopped off by:History:No breakfastEating drinking urinating defaecating normallyNo vomiting/retchingNo coughing, no exercise intolerance, no breathing difficultyNo lameness, stiffness or sorenessItchiness of ears have improved with aural medicationsStill on pred, with last dose being last nightO' mentioned hyperkeratosis of foot pads >> TM explained associated with chronic inflammation/ irritation. TM has advised that either trial booties for walks, or alternatively may be associated with chronic skin isses (maybe trial allergy medication?). TM has advised that some disease processes (like hepatopathies) can result in hyperkeratosis of feet, and if concerned would advise bloodwork be performed. O' declined at this stage.Bright Alert ResponsiveBody condition score 9/10Examination:Mucous membranes – pink moist crt <2sOral cavity – clearTeeth – grade 2Nasal planum – normal no dischargeEyes – eyelid conformation normal, no dischargeEars – right aural haematoma. Mild erythema bilaterally. Mild exudate (light brown) accumulation bilaterally. Lymph nodes - no enlargements notedHeart – normal regular rythymn no pulse deficits, no murmur HR 80Lungs – clear sounds bilaterally, no crackles or wheezeAbdomen – comfortable on palpation, bladder normal, no masses palpatedLimbs – all good range of movement, no swelling or pain on palpationNeck and spine – no pain on palpationSkin – Moderate hyperkeratosis of food padsNails –  clip under GAAnal glands – check under GATemperature – not assessed prior to procedure but monitored throughoutMammary line - no swellings or masses palpatedCytology: EarsLeft - WNLRIght - Mild malassezia spp. Population >> continue with dermotic for another 7 daysTreatment:sedate 0.96 ml methone/ 0.64  ml acp scAnaesthesia:right cephalic catheterisation 20g induce with 4.8ml alfaxan intubate  ETT  maintain on iso, IV Fluids:start on ivft    160ml/hrProcedure: Aural haematoma (right) repair- site clipped and prepped aspetically- elliptical incision made at inner proximal aspect of pinnae about 3cm in length and 1cm at widest aspect- mattress sutures placed with 0 PDS- head bandage placed, with access to right ear for continue medicationMedications:Propercillian 3.2ml SQKetamine 0.15ml IV during wake up (dysphoric)FUC tomorrowPOC Wednesday or earlier if bandage starting to slipSO 10 daysDischarge instructions as follows;Surgery AftercareRudy presented to The Point Vet Clinic today for an aural haematoma repair. His surgery went well and his haematoma has been drained. He has had an incision made into his ear and a small amount of tissue remove to enable appropriate healing of the pinnae. We have placed a head bandage on to aid in reducing contamination of the wound and to apply pressure to stop swelling of the pinnae during healing. If this bandage slips or becomes wet, please contact us for reassessment. Rudi’s ear cytology has been re-assessed today, and there still is a mild yeast infection in the right ear. Please continue his ear medication in his right ear for SEVEN more days (or until advised to stop at his re-check on Wednesday).Rudy has had a general anaesthetic so you can expect he may be little drowsy. We have given some opioid pain relief to stay comfortable, this may cause some signs of dysphoria. By the time this injection has worn off the anti inflammatory pain relief injection will be working to provide constant pain relief for the next 24 hours. Rudy may not want to eat tonight, if he does, you can offer a small amount first, if he eats this well, then he can have a little more later on. If he vomits then withhold food until tomorrow. Rudy has been on a drip so it does not matter if he does not drink. Because of the opioid and anaesthetic he may wet the bed tonight so we recommend a toilet stop just before bedtime. You may notice that Rudy has a slight cough, this can be caused by the anaesthetic tube that was down his throat whilst under anaesthetic and supplying oxygen. This should resolve in a day or so. The bandage on his front leg can be removed in a hour, there may be a slight reaction where we have clipped the skin and placed an iv catheter for his drip. Likewise if we have taken a blood test there may be a slight reaction to the clippers on his neck. This should settle in a few days. We have either used dissolvable stitches hidden in the skin and placed a bandaid over these, or skin sutures which will need removing in 10 days time. Please keep an eye out for any swelling or discharge on the bandage.  If he is chewing at his skin sutures then we can provide an Elizabethan collar to wear around his neck. Rudy will be feeling better in a few days and will want to be more active.  Ensure that he is kept as quiet as possible until we recheck in 5 days time. Limit any jumping, running and active activity (remember that this is a very sensitive area and we don’t want any pulling on that stitch line and upsetting the surgery site!). Lead walk out to the toilet for the next few days. We will give you a call in the morning to see how Rudy went overnight, if you have any concerns please don’t hesitate to contact us – The Point Veterinarian otherwise we will see his back in 5 days for a recheck and if sutures need removing then also in 10 days time. From everyone at The Point VeterinarianScan the QR code to view on our website!--- 21/02/2026 07:52:34 EB:Surgery Follow Up - Resolved - SMS sent for O to follow upHe's ok. Few little cries through the night. Little bit sad and sore today but think he'll be ok.23/02/2026 11:22:23 KG:Going well, no redness or swelling. bandage fell off today but wound looking great, so happy now and is like a new dog kg    Vital Signs    Weight: 32;