C09979349 / invoice 10000

wound on back right leg
owner thinks might need a stitch

Wound over the lateral aspect of the right distal hock. 
Unsure of cause of wound
No lameness noted. 
Is otherwise EDDU+, V/D- and BAR. 

Surgery -  Stitch up. 

Preanaesthetic examination: BAR, vitals WNL, HSDNM.ASA 1

Preanaesthetic bloods: All WNL

Premed: 0.15ml medetomidine +  0.6ml methadone -  IM
Induction: 13 ml propofol slow IV to effect
Maintenance:%Iso and O2 delivered via size 10 ET tube
Fluids: Hartmanns @ ml/hr throughout
Additional medications:
- Nil

Surgery: 
Proximal flap with 4cm penetrating wound through muscle facial and mm bellies. 
Debride non viable flap to healthy edges. 
Flush sterile saline. 
Close fascia with 3.0 filaxyn simple continuous. 
small area will need to heal secondary intention. 
Tacking subcut sutures placed 3.0 filaxyn
external 3.0 cruciate sutures placed externally. 

Bruising of medial stifle. 
some grazes proximal to hock. 
No other penetrating wounds present. 

Melonin and supportive bandage placed. 

Recovered well from the surgery.

Treatment
- Given 0.5ml meloxicam SQ on recovery.
- Will send home with additional pain relief - meloxicam kg dose PO SID 5 days starting
- Amoxyclav 375mg bid po 7days

Plan:
Dressing change thur/fri PM
Ok for O to do dressing change every 48hrs at home until suture removal. 
O is a human nurse so ok with this. 

Recheck incision/stitches out in 10-14 days 
Can Look at vacc at this time. 
 

C2i booster-rhi
Happy and healthy-normal poos. Eating well
advised 8 weeks since last vacc so technicallyneeds booster but up to clients

Vaccs C2i
Hx: EDUD normal. Well. On nexgard spectra . No V+ / D+. On nexgard spectra

PE: BAR BCS 4/6. Temp 38.4
Cv/ resp: HR 92 Normal heart rhythm/ pulses. RR panting Lung auscultation clear. Mmemb pink & m; CRT 1 sec 
Ears: normal
Eyes:normal
Integument: good coat
MSK: normal gait in consult. RHL below stifle mod thickening- 1ry to previous fracture as puppy medial butress right stifle with mild thickening 
Oral cav: great teeth- minimal staining 
Abdo palp- soft and pliable- nil hernias 
LN's normal. 

KC SC, C2i SC- boost in 4 weeks 
not free c2i boost