C10022517 / invoice 10000

Admit for dental GAPONLY
SV

Dental (Extractions)

Hx:
BAR, EDUD wnl, last ate at 6:30pm last night, last water at 6am this morning. No concerns. No changes to appetite, PU/PD etc.

Dental indicated due to severe calculus and tartare, multiple mobile teeth on conscious examination and ginigivitis

PEx:

PreGA bloods: Increased ALP, no other liver enzyme elevated, suspect age related. mild leokocytopenia due to lymphopenia, most likely stress leukogram.Waiting on O call back to confirm ok to go ahead.
Spoke with owner, OK to go ahead, O confirmed no clinical signs, I recommended repeat blood testing when due for vaccinations in May to monitor and O agreed.

Premedication:
ACP (0.02mg/kg) = 0.13ml / Methadone (0.3mg/kg) = 0.39ml  SC
Induction:
Tube size:5
Maintenance: Isoflurane and oxygen

Stage of periodontal disease (0-4)= 4

Procedure:
A gag was placed in the caudal oropharynx. Then a comprehensive examination of the oral cavity was conducted (including a tooth-by-tooth visual examination, probing and mobility assessment, followed by a dental chart).

Radiographs were taken of the entire mouth of the anesthetized patient using an intraoral digital radiographic system.Missing: 109, 209, 405, 410, 304, 311

Once affected teeth have been identified, the following were removed:
Incisors: 301, 401
lump 107-108
Canines: - 
Pre-molars:
Molars:110, 210, 208(complete furcation)

The gingiva of removed teeth were then sutured with 4/0 absorbable dental suture.
A gingival mass was removed from the upper L gingiva location: 107-108

The remaining teeth were then scaled supra- and subgingivally using an appropriately powered ultrasonic scaler followed by a curette inserted subgingivally to remove additional plaque and calculus.All teeth were then polished to assist in the reduction of microabrasions on the enamel.

Other intra-anaesthetic procedures: 
Nails clipped
Meloxicam inj:0.04ml/kg = 

Recovery: Smooth and uneventful

Plan: 
Home with Meloxicam for 5 days
Repeat CBC/biochem at routine vaccination in May
Confirm with owner if want to send the lump removed for histopathology - it may regrow.
Confirmed with Chris - wants to send off for histopathology to be certain of its nature.