C09978994 / invoice 10000

Appointment Reason: Spey, Appointment Notes: SPEY AND HERNIA REPAIRAssessment: OvariohysterectomyAnaesthesia :Sedated with ACP @ 0.02mg/kg + Methadone @ 0.3mg/kg Placed IV catheter in cephalic veinInduction with 1mg/kg alfaxan IVIntubated, ETT cuffedMaintenance isoflurane Hartmanns fluid @ BWx5 ml/h during surgerySurgical procedure (Ovariohysterectomy):  Midline incision, exteriorized ovarian and uterine tissue. Double ligated ovarian pedicles using (2/0 Monosyn) suture.  Uterine body double ligated using (2/0 Monosyn). Muscle layer closed in a simple continuous pattern using (2/0 Monosyn  ). Subcutaneous layer closed in a simple continuous pattern using ( 3/0 Monosyn ). Skin closed in an intradermal pattern using ( 3/0 Monosyn ). Smooth recovery, monitored by nurse.Patient warming: bear huggerTreatment: Inj Metacam @0.2mg/kg SC post opTGH: Metacam @0.1mg/kg OID 4 daysE collarPlan: Keep rested for 10 daysPOC in 3 and 10 days time. Book in for canine extraction once tooth full grown +- 3 months time     Vital Signs    

Appointment Reason: Vaccination, Appointment Notes: Paws App Details:Booking Notes: 3rd puppy vaccinationEDDU: normal Any V+/D+: noDiet: RC puppy kibble Preventatives: NGS monthly Toxins: Current meds: none  Examination: BAR - cute BCS: 5/9MM pink, CRT 1 secOral exam: moderate overshot jaw with base narrow canine - mild indentation of hard palate Cardiac: normal rate and rhythm. No murmur or arrhythmiaThoracic: lung field clear, no crackles or wheezes detectedAbdo palp: soft and comfortable; no focal pain, umbilical hernia Eyes: eyes are bright, clear; no discharge present.Ears: pinna/canals clean bilaterally, no waxy discharge present.Skin: WNLMSK: ambulatory all limbs, gait normal; full exam not performed.Neuro: mentation normal, BAR; full exam not performed today.Genitourinary: NADAssessment: - umbilical hernia - overshot jaw - otherwise healthy Treatment: Vacc: C4Plan:- next vacc in  12m- discussed teeth , NB visit at 6 months of age to see what adult teeth doing. Discussed different options including referral to dentist if needed - correct hernia at desexing     Vital Signs    Weight: 4;       

    Vital Signs