C09979546 / invoice 10000

Reason: ProlapseHx:This morning O noticed that Elsa was licking at her back end excessively O noticed some blood coming from the area and some tissue protruding O presented as soon as she noticed O has noted that she has been licking her vagina on and off for the past 6 months Her groomer did notice that there was a large hair clup stuck in her vulva previously which was removed - 2-3 months agoNo V+ No D+ No Pu/PdDesexedPE:BARMM- pink and moist CRT < 2 secNAD on ausc of heart and lungsNAD on abdo palpNo periph LN enlargement Perineum - vulva folds are protruding - seem to be damaged - unable to assess as becomes aggressive when touching that areaPlan:Needs to be investigated and correctedVery odd presentation due to the fact that she is desexed but could be from constant irritation Has no access to oestrogen cream at home according to ONeeds sedation and possible GA to evaluate as may need stitch upO happy with plan- 1800- 2000 $ quoted Procedure:Pre-med - 0.3mg/kg methadone IM + 5 mcg/kg Medetomidine IMInduced with 3mg of propofol Maintained with isoUterine stump has prolapsed - almost impossible to be reduced full as extremely inflamed - wound on stump present Clipped and cleaned areaReplaced stump Stitched with 0 PDX using a horizontal mattress Some tubing places to reduce cheese wire effect from stitchesRecovery uneventful0.1mg/kg meloxicam given in recovery Home on meloxicam oralHome on amoxicillin RV in 2 weeks for stitches out and will need to reassess as may have shrank in size then and can be replaced    Vital Signs    MMColour: pink and moist ;       Weight: 7.8;       Temperature: 38.6;       HeartRate: 116;       BodyScore: 4.5;       RespirationRate: pant;       BP: 165/75(109);       CRT: < 2;