C10009602 / invoice 10000

Appointment Notes: a/g flushEst $700$350 deposit 0417 230 440no foodno medsyes nailsno special diet rh Examine:Vitals normalAuscultation normalTreatment:Sedation: 0.39 methadone(10mg/ml) + 0.1ml medetomidine(1mg/ml) IM (light sedation) Top up: Alfaxalone slow IV Reversal: 0.1ml atipamazole IM Clipped and cleaned perianal region with diluted chlorhexL AG AH ruptured. ~10mm diameter open wound @ 6 o/clock of anus.Expressed L anal gland- thick grey discharge (came out in 1 long firm segment) expressed with firm pressure. R AG easily expressed thick dark grey discharge. Flushed both glands with saline using 22G catheter tip.  L AG easily catheterised but was not communicating with ruptured cavity even with copious flushing. Flushed through ruptured open wound. Packed both glands with panapex ointmentNails clippedPlan:1. Continue meloxicam 1mg SID PO as directed until finished (O has at home). Due later this afternoon. 2. Recheck anal glands 7 days3. Discussed stools and prevention of future problems: diet / metamucil. 4. D/c instructions provided KOV d/c     Vital Signs    Weight: 9.8;