C09997881 / invoice 10000

History:Admit for repeat xray + bandage change post fracture RH  MT 2,3,4 (21 February) with conservative treatment.O notes- cat content is eating and drinking normally, no vomiting or diarrhea- Sometimes bears weight, sometimes dragsCurrent TxGabapentinMetacam 0.1mg/kgkg sidExamine:Active and alertCrt<2, pulse normal, Heart and resp sound normalAbd palp soft and painlessOrtho: Sedation:Butorphanol 0.3 mg/kgMedetomidine 0.015mg/kgXrays:The xrays show mild-moderate increased fracture fragment seperation compared to previous radiographsP- contineu conserv treatment with increased strict rest and immobilisation- rebanaged with increased immobilisation- repeat xrays in 2-3 weeks- advised can delay healing and surgical stab may be required if further displacement occursProblem List:DIfferential Diagnosis:Treatment:Plan:    Vital Signs    

Reason: Leg Injury RHHistory:SP assessed x rays advised recommend bandage and allow healing without surgery Plan:Skye not interested in eating in hospital so recommend having her at homeStrict cage rest 10d then recheck, remove bandage and re x ray - should be starting to form callus at this stage Then 1 more month of rest and analgesia (metacam until 10d recheck then reassess, gabapentin to continue)Discharge appt booked for 6pm Recheck in 10d or sooner if concerns    Vital Signs    Weight: 4.25;       

Reason: Leg Injury RHLaboratory:X rays show closed fractures of metatarsals 2 3 and 4 minimal displacement Plan:Discussed with o - need assessment by SP or orthopaedic spceialist referral centre to determine if surgical repair recommended - SP back on Tuesday, vs refer but closest specialist is Townsville - o opted to hosp until Tuesday for SP to assess and make plan from there.Treatment:Modified robert-jones bandage applied to RH limb Meds:Metacam 0.1mg/kg SC/PO SID Gabapentin 50mg PO BID Methadone PRN    Vital Signs    Weight: 4.25;