C10010291 / invoice 10000

Reason - lameness 

Now lame LFL
Holding paw up and didn't want to put it down
Gradual onset over a few days 
Initially thought RLF but then started holding LFL upwards 

Recheck

History: edud normal, taking medications well (meloxicam). 
OR good recovery from anaesthetic. 
Bandage change at Jindabyne - vet happy with progress
Weight bearing evenly

Procedure: Removed bandage - paw clean and dry, some furr matting between digits. 
Surgery site dry, no signs of inflammation or infection. Suture holding - healing well. 
Replaced bandage - to keep clean and dry

Plan: Return in 3-5 days for bandage removal; can consider leaving bandage off if healing well. 

Reason: sedated foot exam

Pre-GA Exam: see JC notes

Laboratory: O declined

Anaesthetic:
1. Pre-med: 0.3mg/kg methadone + 10mcg/kg medetomidine IM @ 10am
2. Induction: small amount of alfaxan when incising foot
3. Maintenance: O2 flow-by.
4. Peri-operative meds: 0.1mg/kg meloxicam oral

Surgery: 
Incision made into palmar D4 of RFL over penetrating wound
No obvious FB or drainage tract
X-rays taken with dental plate - 1mm round radiopaque object present 4mm from palmar surface
Wound flushed +++
No FB found but radiopaque object no longer visible on repeat radiograph
Caudal aspect of wound closed with single simple interrupted suture, cranial aspect left 

Plan: 
1. 0.1mg/kg meloxicam PO SID 5d starting tonight, amoxyclav starting tonight
2. Bandage change in 3-5 days
3. REST

Nurse discharge:
Discussed post-op care including wound monitoring, e-collar and rest. Discussed meloxicam dosing.

Note:
Post-op care information emailed to client