C09981672 / invoice 10000

Recheck elbow - owner thinks possibly more antibiotics required

Standard Consultation


Reoccuring wound on the left lateral aspect of the elbow
Slowly growing over last few weeks
Responded to amoxyclav, but returned
Dog is other  wise well, eddu nad 
Not lame


CEx:
Demeanor (BAR) Dog is a bit reactive, but owner can hold him well 
HR (100), Temp (not able to take)
MM (Pink), (Moist), CRT (1 sec), Skin Turgor (OK)
Thoracic Auscultation - Heart sounds (Normal), Lung sounds (No adventitious breath sounds)
Abdominal palpation - (No palpable mass), (No fluid wave), (No pain on palpation)
Peripheral lymph nodes - (Normal)

Lateral aspect of the elbow left front leg, soft swelling, ulceration to the skin over the oft swelling 
Aspirated red liquid 
Cytology in house, +++cocci, neutrophills and RBC

Plan:
restart antibiotics 
previcox if required 

sending sample of lump for culture and sensitivity 

dog should wear cone when unattended 
owner to clean wound with chlohexidine wipes twice daily 

Once infection is cleared up, may need to reassess for an underlying cause of lump, neoplasia etc, but unable to see this in cytology today

O called back - coming to pick up neocort-  Apply to affected area on elbow 2-3 times daily for 5-7 days. Wear gloves! SS

AS or AD - Please advise if ok to continue on meloxicam or not & best spray or wound cream - thanks
Seen by MRJ on 23rd, client phoned Tues 24/02 @ 5pm to advise 2nd day on Meloxicam & had done one softer stool with 3-4 spots of bright red blood about 4:30pm. Reported to be ok in himself otherwise, not vomiting. O did give him a dehydrated roo rib from markets on monday night though. Advice from nurses was it could possibly be caused by either, so stop Meloxicam for now, continue Amoxyclav, and keep to bland diet, with vet to advise if need to change medication or not. 
Wed 25/02 - client phoned 8:43am to say no blood in poo this AM & would like to know what spray or cream can be put on the elbow to help healing & stop him from scratching at it.

AS left message - can use Neocort - O to call if want some dispensed. 
Directions - Apply to affected area on elbow 2-3 times daily for 5-7 days. Wear gloves!