C09989959 / invoice 10000

HISTORY: Lump Removal: Explore im betweeen toes for foreign body 

Premed Examination:

Pre-Anaesthetic Bloods : Yes 
Interpretation of bloods- 

Fluid Therapy: Yes 
22 gauge catheter placed R cephalic v. and commenced on intravenous hartmanns solution at a rate of mls/hr.

Premed exam: NAD
Methadone 1.3ml IM and ACP 0.44ml ( Half )IM, Administered: am 

Induction propofol / alfaxan ml slowly to effect R cephalic v. 

ET tube size: 11.0

Shaved and prep for surgery GA maintenance & Surgery Oxygen and 2/3% isoflurane 
Oxygen Start time: 1110am 
Oxygen Finish time: 1150am 
Total anaesthetic time: mins 

Surgery: Site clipped and prepared for surgery. Left hind third interdigital space (D4-5). Explored with haemostat and alligator forceps initially but no FB identified. Inflamed tissue excised and closed SC with 3-0 PDO and skin with intradermals but ONE suture placed external with 3-0 Nylon. 
Bandaged foot and recovered unremarkably. 
Explored the abnormal tissue and a single long hair removed from the tissue, suspect folliculitis with ingrown hair. 

Surgery Start time: pm 
Surgery Finish time: pm 
Total surgery time: mins 
Post op: Uneventful recovery 
Analgesia:  metacam 1.7ml SC, meloxicam 2.9ml SID PO x 3 days
Antibiotics:  Amoxyclav mg tablets bid PO 

Mass sent for histopathology. 

Discharge instructions provided 

Revisit: 14 days suture removal/wound check
WEIGHT: 44.40

WEIGHT: 44.30
SUBJECTIVE: Assessed the toe, still has drainage track, advised client need to explore. 
Estimate of $300-1200 + drugs, so $450-1400 depending on what is needed. 
Potential for FB, or deep furunculosis or folliculitis. 
Not fully steroid responsive. 
Booked for surgery Monday

WEIGHT: 44.50
SUBJECTIVE: On chicken and veg home diet, doesnt like dry but will eat it. Has been off food a little but chewing at the foot a lot. 
Ears have improved since last visit. 
DH assessed the foot, there is a draining sinus present on the hind foot, appears to be interdigital cyst, potentially lick granuloma. 
Ears are also still mildly inflamed but no pathology present. 

Amoxyclav home for the hind foot, O to use cone to stop him licking. Advised pred also to reduce inflammation in foot and ears. 
O to review in2  weeks.