C09981533 / invoice 10000

HBC bought straight inMethodone 0.9ml IV @5:30pmFluid blus 300ml over 15min, then 5ml/kg/hrExam:L carpus laterally displaced, swollenWounds on dorsal pawHR 140, pantingMMb injectionT 39.7Poss crepitus R dorsolateral chestNo tyre marks or bruises seenConsent given for sedation/workupAFAST/TFAST -ve for free fluids, small bladder (approx 25mm)Sedation:Domiotr 0.15ml IV, additon 0.3ml methadone @6pmRads:F# of distal radius/ulnaNo f# in toesNo rib f#*shoulder/elbow not x-rayedRobert jones badnage placedReferred to VRH for o/n care and sx tomorrowTPR on dischargeRR 20, avg bp 143/86 (93), HR60, T 37    Vital Signs    Weight: 22;       

Reason: Rash On Testicles. CCPBAppointment Notes: Overdue remindersHistory: Presented for reddness on the testiclesO started to noticed some redness and sometimes darker on the testicles But he is not bothered at all energy level still very goodVery anxious puppy very vocaliseO think maybe having mild signs of separation anxiety at homeO dont want him to be desexedEDDU normalNo v+d+No sneezing coughingVaccination deworming UTDExamination: BAR   HR108   RR48   MMpinkBCS 5/9EENT: DG  0/4, wnlThoracic: normal hearth rhythm no murmur, normal bronchoalveolar sounds in all lungsAbdo: soft on palpationLN: wnlNeuro: ambulatory in all 4 limbsIntegument: clean smooth coat, redness on the testiclesMSK: good muscle mass, good ROM in all limbsAssessment: Redness on the testiclesTreatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Plan:Redness maybe caused by contacting on the ground since not causing discomfort at allO still want something to put on so dispense neocortApply once daily if neededAlso recommend having a behavioural consult with PC if the anxiety problem still there when adult    Vital Signs    Weight: 22;       

Reason: GHC, Vaccine And FTW CCKMAppointment Notes: moved from 24/03 CCKMPls as for email - was very hard to hear as was in car a point of call CCKMHistory: Came in for third puppy vaccinationDoing well very activeWas sting by insect 7 days ago and right lip got swollen but came down in few hoursNo obvious discomfort after that Was on a walk yesterday and a stick that he was chewing on accidentally got into the mouthO concern about any injuries in the throat and mouthAlso request some med for occasional rash on hot days, it usually comes down by itself but just want to have something at houseEDDU normalNo v+/d+Diet: dry food with chicken breast and beef minceDeworming UTDExamination: BAR  HR 150  RR 60  MM pinkEENT: WNL, no wounds or injuries in mouthThoracic: normal heart rhythm, normal bronchoalveolar sounds in all lung lobesAbdo: soft on palpationNeuro: ambulatory in all 4 limbsMSK: good muscle massIntegument: clean smooth coatAssessment: Fit for vaccinationTreatment: C4 vaccination given SCNail clippedPlan: Dispense niramine tablets to keep at home. Given one tablet up to 2-3 times a day if needed.Communicate with O if concern about the stick injuries can refer for endoscopy.Came back for annual booster in a year    Vital Signs