C10005097 / invoice 10000

Brachy consult:

current weight = 10kg

BIOP since 9 weeks old
has had ongoing issues with regurg
seen previously for eye issues and regurg - responded to atb's and eye meds

videos viewed for telehealth consult = abdo insp effort +++, stenotic nares 
snoring is now prominant in all positions
no car sickness
no anxiety around car or vets

no current meds
diet = lyka and hills puppy dry food - had horrid GI issues until changing to this - now great


Ax: hx and cx that areirrefutable for inc insp resistance - suspect there is a significan thypoplastic tracheal component along with severe BAOS to be showing such concerning signs at such a young age

Surgery is NEEDED

BOAS grade 2
Risk level = moderate (risk factors = young age, prior aspiration pneumonia)


Plan:
pre op atb's due to hx of aspiration pneumonia - at least 5 days
pre op pred at least 1-2 weeks
pre op nebulised budeosonide - to start asap, ideally BID but most useful at bedtime - this may be life long depending on tracheal ratio and function
pre op metoclopramide for regurg reduction - at least 5 days
trazodone the morning of surgery
ondansetron the morning of surgery esp considering long car trip
small breakfast of soft food only 3-5 hours before admission time

book for march 25th
assume certainly AV, highly likely tonsillectomy, highly likely laryngeal sacculectomy

once has reached skeletal maturity (10-14 months) then proceed with full palatoplasty + revision of nostrils if needed


please send notes to ref vets so they are aware of the plan for Rubble :)

Brachycephalic Breed Questionnaire	
Name	Mrs. Larissa Banks
Address	Street Address: 11 Cunningham Road
City: Goomboorian
State / Province: Qld
Post Code: 4570
Email	lmbanks@yahoo.com
Secondary Contact Details (if applicable)	Jason Banks 0438910552
Dogs Name:	Rubble
Breed:	English Bulldog
Age:	04
Gender:	Male
Neutered Status:	Intact
Coat Colour(s):	Red Brindle
Body Weight(kg):	9
please fill:	15
please fill:	2
Q2. Does your dog breathe loudly while awake at rest?	Rarely (less than once a week)
Q2.1. Does your dog ever snort either at rest or exercise?	Yes
Q3. Does your dog breathe loudly while sleeping?	Frequently (>once a week)
Q4. Does your dog breathe loudly during physical exercise?	Frequently (>once a week)
Q4.1. Does your dog ever make a high pitched noise at rest or exercise similar to sawing wood (not a snort)?	Never
Q4.2. Have you ever noticed increased breathing effort during exercise?	Yes
Q5. Has your dog ever had difficulty breathing during exercise or when excited in WINTER?	Never
Details:	Not been through a winter
Q5.1. How much time does your dog need to recover after physical stress?	Up to 5 minutes
Q6. Has your dog ever had difficulty breathing during exercise or when excited in SUMMER?	Frequently (>once a week)
Details:	Snorts when running, only has experienced short bursts of exercise before rest.
Q6.1. How much time does your dog need to recover after physical stress?	Up to 5 minutes
Q7. Has your dog ever collapsed because of dyspnea (struggling to breathe)?	Never
Q8. Has your dog ever been cyanotic (i.e. blue-purple tongue)?	Never
Q9. Has your dog ever had reverse sneezing?	Never
Q10.1. Regurgitation/vomiting:	Never
Q10.2. Choking on food:	Never
Q10.3. Out of breath during eating:	Never
Q.11.1. Wake up frequently during sleep/restless sleep:	Rarely (less than once a week)
Q11.2. Only able to sleep in certain positions e.g., with the chin up or neck extended or a toy in the mouth:	Frequently (>once a week)
Q11.3. Attempting to sleep in a sitting position:	Never
Q11.4. Make a choking noise or wake up during sleep:	Never
Q12. Does your dog have health problem(s) other than respiration?	No
Is your dog on any medication?	No
Q13. Has your dog undergone any surgical procedure(s)?	No