C10003402 / invoice 10000

Reason: EcC - Burst AbscessPresenting complaint:Sonny presented for assessment of a wound on the right shoulder. The owner first noticed the wound today and observed purulent discharge from the deeper tissues. The appearance of the wound had worsened between 4:30 PM and 7:30 PM today.The owner had a tele-consult earlier today with another veterinarian who advised that management could potentially wait until Monday with at-home cleaning. The wound is suspected to be a bite wound, possibly from another cat, which has now formed a ruptured abscess. The chronicity is estimated to be approximately one week, given the wound appears less sensitive than expected for an acute injury. There is a suspicion that Sonny has been licking the area.Chronic comorbidity:None reported.Current medications:noneVaccination:up to dateParasite prevention:up to dateExamination findings:Bright, alert, and responsive. Very tolerant of handling and examination.CV: HR purring 150. No obvious murmur or arrhythmia. Femoral pulses moderate and synchronised. Mm pink, CRT 1s.Resp: RR purring. Normal lung sound. Normal respiratory effort. No wheezing or crackling.Abdo: comfortable on deep palpation. No obvious masses.Msk: two ~1x1cm mild wound on right lateral shoulder  - mild to moderate erythema, moderate swollen and painful, small amount of pus and serous discharge. On palpation of the right shoulder region, the surrounding tissues feel moderately swollened. Ambulatory with no obvious lameness.Neur: normal mentation.LN: bilaterally symmetrical, no obvious enlargementWound clean - shave around the shoulder area, flushed with saline. not tolerating explorationAssessment:Ruptured abscess on the right shoulder, likely secondary to a bite woundActive draining - however cannot rule out underneath pocketing/seeding infection at deeper tissuegold standard include sedation with proper wound clean and explorationPlan:amoxiclav 20mg/kg PO q12h for 7 daysbuprenorphine 0.02mg/kg TMS q8-12h for 3-5dtopical diluted chlorhex wipe around the lesion if neededecollar on all timerecheck early next week with reg vetClient communications:Discussed the nature of the wound, likely being a ruptured abscess from a bite. Explained that the tissues around the wound are thickened and sore. Two treatment options were discussed. The first option, considered ideal, involves sedation for a thorough wound exploration, debridement, and flushing to remove all debris and infectious material, followed by antibiotics and pain relief. The second option, which was elected by the owner, involves conservative management with oral antibiotics and pain relief following an initial wound clean, with the understanding that the wound needs to be monitored closely.Advised the owner to keep the wound open to the air to facilitate drying and healing, as the exposure to oxygen is beneficial. Explained that if the wound had not ruptured on its own, the recommendation would have been to lance and drain it. Advised on signs of worsening infection to monitor for, including increased purulent discharge, worsening appearance of the wound, increased pain/reactivity, lameness, or systemic signs such as inappetence or lethargy. Advised a recheck with their regular veterinarian on Monday to ensure the wound is healing appropriately. The possibility of recurrence was discussed, explaining that if a deep-seated infection persists, the abscess may reform after the course of antibiotics is finished. A cone and antiseptic wipes were provided. Advised the owner to prevent their dog from licking the wound    Vital Signs