C09984596 / invoice 10000

History:O walk in emergency, initially some confusion said HBC but then said the larger family dog bit Lady. Exam:Screaming in pain, had to blanket wrap and get straight onto oxygen and sedationmultiple large lacerations at least down to muscle layer over thorax both sides - at least 2-3 on each side, look like bite woundsSlight flail chest on left sideemphysema severe from neck to over abdomen on all sides and dorsal surfaceleft pupil constricted, right dilatedpale, not able to assess mouth as bitingabdomen doughy and feels like air or fluidsuspect multiple rib fractures at least, unable to confirm if spine and forelimbs alsoTreatment:oxygen fly by, methadone with slight domitor to facilitate catheteralfaxan IV to keep restrained, shock bolusAG discussed with O, ideally transfer to emergency but will not likely survive trip. stabilised enough for radiographs, massive lung damage, suspect diaphragmatic hernia, multiple lungs broken, sternum suspicious of break also, break with scapula at level of notch. O opted for euth and burial at home.     Vital Signs    

Appointment Notes: 3rd puppy vaccine. CHNurse Pre Questions:Flea Tick and worming and Date last given:   simparica trio utdIndoor outdoor Pet:   bothFood currently feeding:   RC kibble & wet Fish oils and current medications:   nilVaccinations:   3rd today History:was itchy at first but has not settled. Is going really well, DUDE fine, no d/v/c/s. On simparica trio for heart worm and tick preventionExamination:BAR, eyes clear, MM pink, CRt <2, occlusion looks good, HR 180, sounds normal, RR wnl, ab palp soft and compliant, temp 37.6Assessment: Fit for vaccinationVaccination:   Duramune C3Expiry:   1.11.2024Batch number:    5262006PLAN:Discussed desexing at 6 months of ageA week from today can start going out and about, socialising etc    Vital Signs    Weight: 1.8;       HeartRate: 180;       

    Vital Signs