C10017741 / invoice 10000

Admitted:  Aural haematoma L ear $1300-$1500, NAILS

Consent form completed

Physical Exam:
HR (152), no murmur or arrhythmia, pulse strength normal
RR (panting), chest clear, effort normal
MM pink, moist, CRT <2 seconds
Temp (wnl)
GA risk factors (AGE + overweight++)
IV catheter placed

Supportive Care:
Blood test (PREP II and PCV: ) first 2 blood tests too lipaemic to read liver enzymes, but tried a third time and success, very mild elevation of ALP and glucose but nothing alarming + lip++
Fluid therapy : Hartmann's LRS (147)ml/hr 

Sedation:
Acepromazine (0.4)ml SC 
Methadone (1.17)ml SC 

Induction and Anaesthesia:
Induced with Alfaxalone (5.14)ml IV
Maintained with Isoflurane and oxygen at 2L/min
2nd methadone given intra op (0.58)ml IV and (0.58) ml IM. Total (1.17)ml 

Surgical Report: clipped and cleaned ear pinnae, sterile prep, chlorhex, metho, 
incision made on inside of pinnae approx 1.5cm long, incision extended into more diamond shape so it can continue draining, 
emptied approx 15ml blood and small and large blood clots, 
flsuhed with 30ml sterile saline until \clean, 
placed vertical sutures through pinnae into buster pad around inicison and over whole area of haematoma, 
trimmed buster pad to fit ear and wrapped, with head bandage, softban, vetwrap and elasto caudally, leave on as long as possible to stop ear shaking, also e collar on, 

ear itself was so mildly inflammed, with no stenosis or discharge so this might have all been from the hair on tymp membrane secondary to general pruirits and her putting her foot in her ear to itch??

Nails trimmed
Anal glands expressed 
KC vaccination given. Batch #;15608, Exp: 10/26 

Medications Given:
Meloxicam (1.17)ml SC


Medications Home:
Meloxicam (1.9)ml PO SID for (5) days starting tomorrow. Total: (9.5)ml 
weight loss strongly reccomended

PLAN- RECHECK WEEKLY FOR 3-4 WEEKS AND THEN WE CAN JUDGE WHEN TO REMOVE SUTURES - E COLLAR TO STAY ON,