C10010232 / invoice 10000

Veterinarian Name: Kimberley van der SchyffReason:Evaluation of a palpable abdominal lump and follow-up regarding previous CT scan findings concerning respiratory signs.History: The owner reports that Cinnamon pants after minimal exercise and sometimes breathes heavily. A high respiratory rate is noted when he is asleep. No coughing has been observed. A previous CT scan revealed some changes in the lungs with suspicion of asthma. The owner recently palpated a small, soft lump on the abdomen.  EDDU: Normal  Vomiting or Diarrhoea: No V+/D+  Diet: Royal Canin Dental dry food and Fancy Feast wet food.  Vaccinations:  UTDPreventatives:  Monthly productCurrent medications: none Behavioural concerns:nonePhysical exam:General Appearance: BAR  Behaviour: Nervous purr but calm and curious.  Vitals: HR:208 bpm; RR:60 (purr) ; T:38.9; MMC:pink ; CRT:<2  Hydration: normal  BCS: 6/9  EENT: Eyes clear, no evidence of conjunctivitis, no discharge or blephrospasm; no swelling or discharge to the external ear canal, ear pinnae clear; no nasal discharge; Mild gingivitis with some redness noted.  Cardiac: normal rate and rhythm, no murmurs on auscultation  Resp: Increased lung sounds auscultated. This may be stress-related.  Abdo: A small, non-reducible umbilical hernia is palpable at the umbilicus.  Urogenital: MN Integument: no external parasites noted; no erythema or pruritis  Neuro: proprioception NAD; NSF  Musculoskeletal: ROM WNL, no palpable abnormalities  Lymph Nodes: Peripheral LN's WNLClient communication: A discussion was had regarding the physical exam findings. The palpable abdominal mass is suspected to be a small umbilical hernia. Surgical repair options were discussed; while the risk of complications from a hernia of this size is low, surgical repair is a simple and curative procedure. The possibility of performing the hernia repair concurrently with a future dental cleaning was also discussed. It was explained that the gold standard is to perform these as separate procedures to minimize infection risk, though combining them is possible.    The ongoing respiratory signs were also discussed. A plan for today was recommended, including pre-anesthetic bloodwork, chest x-rays to investigate the respiratory signs, and surgical repair of the umbilical hernia. It was explained that the results of the x-rays and the previous CT scan will be discussed with a specialist, Dr. Richard, next week.    Problem list:-   Suspected umbilical hernia-   Suspected feline lower airway disease-   Mild gingivitis-   OverweightGA and radiographsPLEASE ENSURE VETS HAVE FINISHED EDITING XRAYS BEFORE THEY ARE FINALISED ON THE XRAY COMPUTER (Delete this note when completed)PLEASE ENSURE S8, NSAID & MISC. FEE QUANTITIES ARE ADJUSTED TO CORRECT AMOUNTS BEFORE FINALISING (Delete this note when completed)Procedure: premed: Methadone 0.2mg/kg 0.12ml and Medetomidine 0.005mg/kg 0.03ml IV @ 10:41am IV catheter placed, alfaxan induction 1.5ml slow IV to effect, intubated size 4.5mm cuffed ETT, maintenance isoflurane.Routine GA no complicationsIVFs - hartmanns @ surgical rates (3ml/kg/hr) throughout procedure.Radiographs:Chest Xrays taken to be sent to specialist in BundabergProcedure: Umbilical hernia repair: incision made over hernia with 15 scalpel. Blunt dissection of tissue around protruding fat. Fat reduced and linea alba closed with 3/0 PDO using cruciate sutures. SC and intradermal 3/0 PGCL sutures. Meloxicam 0.05mg/kg 0.5mg/ml 0.6ml PO on recovery Plan: Meloxicam 0.05mg/kg 0.5mg/ml 0.6ml PO SID for 4 days starting tomorrow Post op check in 3-4 days and 10 days    Vital Signs    Weight: 6.14;