C10009800 / invoice 10000

Reason: Rads, US FNA Appointment Notes:   25.02.2025  TBAdmit with jayFastedNo allergiesHad gaba at 6am this morning - not on anything other meds17kgCpr yesNo V+ or D+Is due for lepto + possibly something else that o would like to do today - we are their primary vetRECHECKRecord entered by: Jane chong vet studentChecked by: - MAIN PROBLEM: chronic swelling on front paws- LAST CONSULTATION DATE:- REASON FOR RECHECK: chronic swelling on front paws, started to have generalised swoelling in all four paws. - RELEVANT CHANGES: swelling was localised previously, but now it is more generalised. - CURRENT MEDS: (list the mg/kg dose and frequency, duration and last dose): had Gabapentin at 6am today. PHYSICAL EXAM (change accordingly)- Weight: 17.2kg- Attitude: Bright, alert, responsive - Mucous membranes: Pink, moist- Capillary refill time: Less than 2 seconds- Body condition score: 4/9- Femoral pulses: Strong and synchronous	 - Lung auscultation: Normal lung sounds- Heart auscultation: No murmurs, no arrhythmias- Abdominal palpation: Non-painful, no enlarged organs, masses nor other abnormalities palpated - Urogenital: Bladder soft, not painful- Peripheral lymph nodes: Small, soft, symmetrical- Eyes: Within normal limits, no redness nor discharge, normal retropulsion - Ears: no discharge no inflammation- Nose: Within normal limits- Oral cavity: no ulcers nor visible masses- Skin/haircoat: Swollen digits on all four paws, first noted on the left forelimb on 13/12/2025. Red nodules were found on the right forelimb between digits III and IV. Mild swelling of the digits is also present on the hindlimbs.- Musculoskeletal: Ambulatory, no lameness noted, no joint effusion. No neck pain on manipulation, no spinal pain on manipulation.- Thyroid palpation: not assessed PROBLEM LIST1. Swollen digits on all 4 paws. Particularly on LFL, raised nodule was found on LFL and RFL between digits III and IV. 2. Instability of phalangeal joint on hindlegsSedation plan: 1. 0.12mL medetomidine IM - 7 mcg/kg 2. 0.52mL methadone IM- 0.03mg/kgINVESTIGATIONS & MAIN RESULTS1. Radiograph: mild degenerative changes on front left limb and left hindlimb (digit IV)2. Ultrasounography: no soft tissue injury and no FB found. ASSESSMENTThe instability of the phalangeal joints in the hindlimbs may be due to soft tissue injury, such as a ligament tear, however, further advanced imaging, such as CT or MRI is required to rule this out.TREATMENTVaccines: 1st nobivac lepto 2 SC inj location L neck (Batch: A003A02). 1st Canigen KC SC inj location between scapulas (batch: 2502818). Due Lepto & KC booster within 2-4 weeks. C3 due in may, bring forward C3 when lepto & KC vac given. Plan (incl. alternative options):Record Entered by:Record Checked by:Procedure:Staff Anaesthetist:Primary Student:Primary Clinician:Anaesthetic start time:Anaesthetic end time:Length of anaesthesia:Length of surgery:Physical exam:Heart rate:Respiratory rate:Temperature:Body Condition Score (1 to 9):ASA status:Comments:Pre-anaesthetic Medication:List drugs used, does in mg or mcg, route of administration and time given:Effect:Induction time:Preoxgenation (Y/N):Induction agent/s, dose in mg or mcg, route of administration and time given (List):Quality:ET tube size and depth:Comments:Maintenance:Maintenance agent/s and carrier gas (List):Fluids (List):Ventilation (spontaneous/mechanical):Comments:Analgesia:Local technique/s used, does in mg or mcg and time performed (List):Infusion/s (List):Other analgesic drugs, does in mg or mcg, route of administration and time given (List):Complications and how each was addressed (List):Interoperative medication:List of drugs used, does in mg or mcg, route of administration and time given:Recovery:Extubation time:Temperature:Comments:Postoperative Plan and Medication:Nerve blocks performed (time of administration and duration of effect):Post-op analgesia plan (list drugs and doses):Rescue analgesia plan (if patient is pain scoring >4/20 or 6/24):Monitoring used during rcovery:Interventions:Comments:Record Entered by: Record checked by:Diagnosis:Current treatment protocol:History since last visit:Physical examination:Weight: BCS:Temperature:Heart Rate:Pulse Rate and quality:Mucous Membranes:CRT:Lymph Nodes:Other findings:Assessment:Plan:Procedure and outcome:    Vital Signs    Weight: 17;       

Reason: Ultrasound Toe Swellings +/- FNAAppointment Notes: Rads +/- US +/- FNA    Vital Signs