C09986312 / invoice 10000

sedate/General Anaesthetic for cast change, FNA of popliteal LN and immunohistochemiostry

Surgical admit

PROCEDURE/s (Cast change, FNA popliteal lymph nodes)
Additional concerns, additional procedures? (Y - new lump found on dorsal head R temple area - OK to FNA today)
PABT (N) 
Vaccination status (utd)
Microchip (already has)
Nail trim (Y) EAG (Y)
Medication? (Y) Last given and type (Amoxicillin, Carprofen, Gabapentin - almost out of amoxicillin)

Fasted? (Y) 
Been unwell? (N)
Any vomiting or diarrhoea recently? (N)

Client details UTD (Y)
Insured?(Y) 


### Admitted ###

Exam:
BAR
mm pink, moist
Thoracic ausc nad
Integ: 
- New lump deep dermal R temporal/dorsal head area - quite firm, approx 8mm diameter, mobile
- Sx site from lump removal is moist and crusted - likely crusting with antiseptic lotion O has been using
LN's: R popliteal is palpablwe and mildly enlarged

Methadone 0.8mL + ACP 0.2mL  - mild sedation
IVC placed

Propofol total 32mL used throughout procedure

Removed cast - has been rubbing over top aspect slightly at caudal aspect
Had rubbed through the bottom layers so stirrups not attached anymore (rubbed through stirrups)
Foot very smelly and greasy

Cleaned foot and between pads with dilute betadine
Dried with swabs and hair dryer 
Applied baby powder between toes

Cotton wool between toes
Stirrups with kendall tape lateral and medial
softban 3 layers
tensile gauze 2 layers
cast applied - stirrups applied same side
Elastoplast to hold cast together
Tape around rough edge of cast
Softban taped to top of cast to try and help stop any rubbing
Vetwrap covering cast and covering toes at bottom
6 x layers of elastoplast over bottom (3 crosses)


Surgery site cleaned with dilute betadine - is moist and mildly discharging serous/purulent type material
Placed melolin dressing with small amount of flamazine and fixomul covering


FNA's taken x 2 of R popliteal LN, no other LN's palpable

FNA taken of lump on head
Both to send to vetnostics


Plan:
- Repeat bandage change in 5-7 days - change both cast and fixomul dressing
- Add clav tablets 7 day course
- Await FNA results
- Immunohistochemistry - round cell panel requested via email to vetnostics