C09985351 / invoice 10000

Reason: Ear Flush + HaematomaAppointment Notes: 2/3 -Pre op info emailed, wvHistory: Itch seems well controlled R ear haematoma, bilat infectionHere today for ear flush + clip nails + clean feet + R haematoma + bloods Current meds: zenrelia SID, tacrolimus BID, artifical tears SID, macrolone EOD (last dose yesterday)Examine: Presurgical examination:See TPR tab + prevLaboratory: taken following premedicationALT 141 U/L 10 - 125 H ALKP 630 U/L 23 - 212GLU 9.42 mmol/L 4.11 - 7.95RBC 4.36 x10^12/L 5.65 - 8.87 L 	HCT 27.8 % 37.3 - 61.7 L HGB 10.1 g/dL 13.1 - 20.5Premed:  Medetomidine 10mcg/kg + methadone 0.3mg/kg admin IMGA:  alfaxolone 2mg/kg IV to effectContinous monitoring HR, RR, BP, SP02IVFTEars flushed with saline until clear - large clumps of hair and debris bilat (R>>L) Cytology: Ear swab R + yeast, occasional cocciL + yeastR ear aural haematomaZ shaped incision over haematoma, edges trimmedVertical sutures placed nylon 2/0Polox enro/keto/dex admin bilat 3mlNails trimmedFeet washed with chlorhex S + malaseb washTreatment:  Cephalexin 500mg BID 10 days (22mg/kg)Continue pred 10mg but SID for 3 days, then EOD ongoing - O has at homeEliz collar TGHPlan:  Recheck once weekly with a vet for 3 weeksRepeat polox treatment at 1st weekly recheckREMOVE SUTURES AFTER 3 WEEKS - no earlier.    Vital Signs    Weight: 23.2;