C10007042 / invoice 20000

Post- PHOL billing    Vital Signs    

Reason: L3 - CON2 - Cut Lip Left Hand Side Of FaceAppointment Notes: In Con2 to contain bleedingPresented and seen by Dr   Michelle Hahm @ Time/Date 2304 9/3/2026History:Sustained a cut over left upper lip from the fenceline (due to other two neighbouring dogs). Intermittently bleeding. No health issues. Examination Findings:Objective:General demeanour: BARTemperature: 38.7Cardiovascular: no murmur or arrhythmia, FP synchronous and adequate bilaterallyRespiratory:  no overt bronchovesicular sounds, normal effort, no cough/sneeze witnessedAbdomen: soft, doughy abdomen, no pain elicited, no. mass effectPeripheral LNs: WNLEyes/Ears: NSFIntegument: WNLOral exam: NSF Musculoskeletal: comfortable on all ROM of limbs, spinal palpation, neck manipulation.  Gait: Normal, no lamenessNeurological: Normal mentation, CN normal, CP x 4 normalRectal exam: DNPMethadone 0.2mg/kg IM on presentationDissolved TXA 500mg and applied into wound directly. Placed pressure over region to stop bleeding. Started to strain to defecate (likely from stress) in consult and vomited once - recurrence of bleed.Medetomidine 10ug/kg IM IVC placedPropofol to effect - intubated with 8Fr ET TubeMaintained on O2, no isoInitial IPPV due to breath hold from propofol.Continuuous ECG, NIBP, ETCO2, SPO2Clipped and sterile prepped region - flushed with sterile saline. Closed in two layers - subcutaneous with simple continuous PDS 3/0,  skin with PDS 3/0 cruciate sutures. The ventral and partial inner aspect of lip affected - closed with surgical skin glue. Reversed with atipamezole IMMaropitant 1mg/kg IV Amoxicillin 300mg BID for 5 daysParacetamol 250mg TID PO for 3-5 daysTo hold off on NSAIDs due to v+ and soft stools in consultE-collarS/R in 10-14dInitial Assessment:Lacerated upper lip marginClient Communication:Advised there may be a slight tightening effect of the skin, as there is a "chunk" of skin missing. This will not cause any functional issue. Admission for stitch up tonight vs tomorrow at GP vet. Elected to admit.SMS'd O for update post-recoveryPlan:To organise discharge in the AM--- 10/03/2026 08:39:18 AYS:BAR, very stressed in cageCalled owners to come for discharge this morning    Vital Signs    

Reason: Split Dew Claw, BleedingPresented and seen by Dr     @ Time/DateRegular Vet:Presenting Problem: History:O had her at the park, chased after a ball then stopped, lifted her right front paw. The dewclaw on the R side was bleeding and was a bit proppy, does lift it when shes standing. Is no longer bleeding. Is not on any medications at the moment other than cytopoint injection. Examination Findings:General demeanour:BARTemperature: DNPCardiovascular: 140, MM pink, CRT 2 secRespiratory: pantAbdomen: ComfortrablePeripheral LNs: NADEyes/Ears: NADIntegument: LFL dew claw split mid clawOral exam: NADMusculoskeletal: NADGait: NADNeurological: NADRectal exam: DNPInitial Assessment:Torn dew clawInitial Plan:Offered1. Sedation and removal2. Pain relief and monitoringO opted for option 2Treatment:Sent home with meloxicam 0.1 mg/kg PO SID for 3 days and a bandage to remain on overnight with plan to remove it Sunday morning. If keep bleeding or caught again, consider option 1 to remove. Monitor for any infection once bandage removed. Referring Veterinarian Communication: Daily update emailed to referring vet : YES/NO Time: Client communication:    Vital Signs    Weight: 14.9;