C10004524 / invoice 10000

Appointment Notes: ***GAP ONLY***VETSTORIA - Finn (Dog) - 2 Consult extended – more than ONE problem/ second opinion [Clinician : Dr. Perin Patterson(No Preference)] - 1. Back right? Leg. Severe limp. Also needs meds (cartrophen, Baransa) Kennel cough vaccine. Also looking for some medicine for his leg. -Web BookingClient name: Amanda SaladineContact number: 0437498866Email address: amandasal01@yahoo.comPatient name: FinnAppointment Notes: ***GAP ONLY***VETSTORIA - Finn (Dog) - 2 Consult extended – more than ONE problem/ second opinion [Clinician : Dr. Perin Patterson(No Preference)] - 1. Back right? Leg. Severe limp. Also needs meds (cartrophen, Baransa) Kennel cough vaccine. Also looking for some medicine for his leg. -Web BookingClient name: Amanda SaladineContact number: 0437498866Email address: amandasal01@yahoo.comPatient name: FinnHistory:BIB: Amanda and AliciaThink it is the RH = but is hard to tell - initially it was definitely the R and he was crying piteously when trying to move on it.  Due for cartrophen, beransa and KC vax today also. Last night had 300mg gabapentin and 1 adult 500mg panadol yesterday.   Lameness started on Sat AM acutely - he raced up the back after a whipper snipper and then pulled up lame immediately after. No breakfast this AM.  Did not want to get into the pool and would not jump onto the bed last night. Client Comms:Offered lepto vaccine - O declined. Examination:Reduced weight bearing on the RH in consult but he is not very keen to show us for sure which leg is the issue.   Unable to touch him otherwise - aggressive.Plan:Sedate on admission and hand procedure to vet BS.GA to allow CCL radiograph bundleGive: KC inj, beransa and cartrophen dispense more gabapentinInitials of primary nurse for procedure: TabPre Anesthetic Exam:  1Risk Level (1-5): 1Laboratory: Pre Anaesthetic labs: within normal limits  PCV/TP: 41/70IV Fluids:  22g IV catheter placed in R lateral saphenous v.Anaesthesia:   Premed (PP): Meth 0.3mg/kg - 0.93mL and medetomidine 0.01mg/kg @ 9:50am - 0.3mL, THIS WAS SO NOT ENOUGH. BS: Further 0.15mL (0.005mg/kg) medetomidine given @ 10:30am, still growling and unable to place IV catheter1.2mL (0.2 mg/kg) midazolam IM @ 10:45am - then able to place catheter at 11.30 after he was left to chill for a good long period.Induction:  Pre-oxygenation for 10 mins for patients over 7 years old or brachycephalic: no unable as was too aggressive. Had preoxygenation for 2 minutes then during induction Induction with Induction with _6.5_mls propofol (4mg/kg) given IV  Maintenance:  Intubated with size _11.0_  ET tube and maintained on isoflurane _1.5_% and oxygen _1.5_L using rebreathing (30ml/kg/hr) circuit for 39 mins Other drugs given during GA: _5_mls propofol additional as got to light while repositioning for x-rays and started to vomit. Anaesthesia was mostly stable however Would get to light while repositioning. Extra propofol needed when first repositioning as started to vomit. Suctioned out vomit with head lowered and no changes in breathing after. Recovery was mostly stable and he woke up very quickly. Did have another 3 vomits in recovery but had enough tongue control that this wasn't an issue.  Procedures performed:   RadiographsVaccinationOA needlesDispense more gabapentinNails - nothing needed to be trimmed.Examination:Under GA - no draw present in either stifleNo injury found in either of the feet or tarsi Radiology:    Site:   Stifles, hips and lumbar spineType of Views:   Lateral stifles, VD pelvis, lateral lumbar spineFindings:  Very poor alignment in the hips - worst on the LHS.  Lumbar spine no issues. No intra-articular inflammation in either stifleAssessment:  No evidence for boney issue or CCL issue at this time.Diagnosis: Soft tissue injuryMedications:    Pentosan:    0.95ml administered  SQ into the scruff    Vaccination: Nobivac Bb/Pi (Bordatella bronchiseptica & Parainfluenza) given sc in the right side of the scruff - booster in 12 months.Beransa 20mg - given SC in the neck scruffDispensed another box of 300 gabapentin tablets.10 x 100mg carprofen dispensed for SID dosing - expect a 7-10 course would be needed.Plan:  Rest for the next 7-14 days. Re-assess in 14 days if remains lame. Presented by:  Alicia and AmandaPrimary contact today:  Alicia 0437498866Admitting nurse: TMCurrent meds: Gabapentin as needed (had last night)Other concerns:     Vital Signs    Weight: 30.8;