C09998365 / invoice 10000

Appointment Notes: tail amputation, getting worse- see hx JMAppointment Notes: tail amputation, getting worse- see hx JMKPB & TRSPre-medication:0.04mg/kg acepromazine + 0.3mg/kg methone IM- good sedation Placed on IVFT- Hartmans. 3ml/kg/hr during prep & recovery + 6ml/kg/hr during procedure. Preoxygenated 5 mins. INduced with 6ml alfaxan IVIntubated size 10.5 cuffed ET tubeBandage removed showing some evidence of pressure sores higher than initial wounds at proximal aspect of tip. - requiring higher tail amputation bupivicaine 10ml as ring block 3 tail joints higher than amputation site. metomide 4mls IV- large dog on back- proactive to prevent posisble bloat riskKetamine 0.2ml bolus IV at start of surgeryMethone top up 0.3mg/kgLateral incisions either side from amputation site distally & circumfrencially Vessels ligated iwth 3-0 PDADisarticulated joint (~5 tail joints from tail base). Skin flap folded ventrally. Skin edges closed with simple interupted using 0 No anaesthetic or recovery concerns. No bandaged placed as aim to try manage without due to potential concerns with blood supply to tissue vs is tissue just dying due to banage being too tight. Add in metronidazole 10mg/kg PO BID 5 days. Finish amoxyclavContinue Carprofen SID for ~7daysGabapentin if needed. Revisit in 3-5 days. Tail kept in formalin for now.     Vital Signs