C09980171 / invoice 10000

inhouse bloods oklump top of head caudal to right earo said was a lump there priorFNA - mainly neutrophils and rbcslikely inflammed/infected lumpcalled O - likely need removal and not just exploring as likely a lump not a FB abscesspremed medetomidine 0.1ml and methadone 0.25ml SQGA alfaxan IV induction intubated and maintained on isoflurane and O2IV fluids hartmannscalled O - needs 4 extractions at least and has swelling left lower manibular area where 1st PM is missing so possible cyst, recommend dental xraysdental xray left and right mandibular area - both 2nd PM have only single root instead of 2 roots - left 1st PM present with dentigerous cyst likely, if not then take biopsiesremoved skin mass top of head right side - incised over mass no FB found - removed mas with moderate margins.  Bleeders cauterised.  SQ closed with pds 3-0.  Skin closed with supramid 3-0Dental - 6 extractions - left lower 1st and 2nd incisors, 2nd M and left upper 2nd MIncised over the swelling left mandibular 1st PM area - fluid filled - dentigerous cyst - removed 2nd PM and found 1st PM and removed - debrided cavity and flushed. Re xray post extraction.  Closed with pds 4-0.  Other sockets flushed and left open.  Scaled and polished restduplocillin 1.2ml SQatipamezole reversal 0.05ml SQmetacam 0.2ml SQmetacam 1mg one sid with food x 3send skin mass for histopathologysuture removal in 10 -14 days

H:O noticed swelling with pustular discharge since yesterday. otherwise edduf. no v or d.Exam:MM:PPCRT:<2dental: grade 2Nose:wnlLN:wnlEars: mmild discharge but no rednessEyes:wnlThoraxsounds okAbdomen:wnlInteg: soft tissue swelling with pustular discharge on the dorso medial aspect of the R ear Msk:wnlNeuro:wnlReprownlPer rectumwnlAssessmentFB? mass?Plan:to perform surgical exploration tomorrowgiven duplocilin 1.2ml and metacam 0.4ml SC

advise blood is okto monitorotherwise responded well with apoquelto call back if there is any issue