C09996407 / invoice 10000

Appointment Reason: Castrate, Appointment Notes: Castrate KE emailed handout & admit + sent smsEstimate: $525Medications: NO Fasted: YES Does your pet have any food allergies or requirements? NO PAI bloods: NO Retained testicles: NOConsent for deciduous extractions: NO Hernia repair: NO HL dew claws removal: NO Extras: NO Consent in case of GA complications:  YES Contact: 0400004130IM TPR: HR 124, RR 30, PInk 1 sec, T 38.9, QARboth testicles descended, no hernia or deciduous teeth 24 G catheter placed on RFLPremed: Methadone 0.25 ml, Dormitol 0.03 ml and ACP 0.09 ml IM at 10:15 amInduce with 2mls alfaxan IV, place ET tube and maintain on iso/O2Stable GA throughoutIV fluids throughout at 45mls/hrno GA complicationsRoutine prescrotal closed castrationWoke up wellGave 0.3msl meloxicam SC for post-op pain relief To go home on meloxicam 0.55mls sid with food for 5 days from tomorrow am     Vital Signs    Weight: 8.8;       

After surgery he was oozing alot scortum fille dup wth blood, frank blood down legs Rang O and informed o concerned suture has slipped and will re-GA and inspect woundGAve 1ml alfaxan IV, inspect wound, all ligatures intact oozing from all surfaces.  activated clotting time = 4 mins Close wound with 2-0 monosyn and 3-0 riverlon Bloods for coag and FBC GAve 1.6mls koagulon in case of rat bait Gave 1.3mls transexaminc acid (15mg/kg_ slow IV (over 30 minsSpoke to O, suspect clotting disorder.  O said they went to NEVs 3 weeks ago for excessive bleeding from mouth and differential was coaguloapthy Needs bloods sent away and to go to NEVs, may need blood or plasma transfusion TPS recommends also see if vetnostics doa haemophilia test and add that on Rang vetnostics, do not have a haemophilia test HAve all results sent both to us and TPS/NEVsNEVs quote 2000-3000 overnight     Vital Signs    

Reason: dislocated legHistory:  First noticed yesterday, cried throughout the night. Non weight bearing LFL. Other limbs fine. Play rought at home but no traumatic injury observed.  No breakfast. Otherwise bright and good energy. No vomtiing or dia+ O aware of.  is a bit of sook at home O says Exam:BAR, mm pink, crt <2eyes & ears: NADHR:  172, lung fields clearabdo: comfortable Spinal: no pain on palpationGood ROM of head/neck Grade 5/5 lame on LFLLFL - Painful on manipluation and palpation of shoulder, no pain on palpation of paw, metacarpus, elbow, no external wounds or swelling. Other limbs comfortable, LHL click/loose patella, but comfortable and good weight bearing  LN; NAD Temp: 38.7Assessment: non weight bearing LFL - pain consistent from shoulder joint  - concerns soft tissue injury vs panosteitis (humeral) vs fracture  vs less likely septic OAAll other limbs and spine ok OPTIONS: 1. Recommend sedation + x-rays (FL's and neck and thoracic spine) today ($650) 2. Rest and anti-inflams O would prefer x-rays today and requests we x-ray the HL's as well (est $1050-1100). O happy to go ahead.  Treatment: Sedated with: 0.05mls butorphanol + 0.13mls medetomedine IM. Good sedationIV cath placed. Topped up with 0.2mls alfaxan IV to effect. Whole body/major joint x-rays taken. Normal serosal detail Fairly normal bone/skeletal and growth plates expected of a dog of his age in all joints. No obvious fractures, luxations or soft tissue swellings associated with LFL (shoulder). While sedated - consistent pain on palpation of L shoulder.   Suspect soft tissue injury vs panosteitis (humeral).  Plan: Strict rest 2-3 weeks and pain relief. 0.2mls meloxicam inj S/C0.3mls melxoicam PO SID 5-7 days50-100mg gabapentin PO BID 7 days 50mg  Paracetamol Liquid 100mg/ml PO TID for additional pain relief.  0.25mls buprenorphine inj IM at 2pm. Communication:  Offered sending x-rays for specialist interpretation vs monitor response to treatment. If no improvement or worsens then next step referral to an orthopaedic specialist. Mr elected to monitor response to treatment and declined sending x-rays to specialst. TGH 2.30pm - 3pm. 24/12/2025 2:49:20 PM VVGGave Bup IV at 1Happy in cageAte chicken and id foodSleeping most of the time in bedRemoved catheterDischargued at 2;50pm    Vital Signs