C10029419 / invoice 10000

Reason: Dental spa and extractionObjective: BAR - nice dog. HR/PR: 120bpmRR: ClearTemp: 38°CMM: PinkCRT: Slightly tackyStatus: ASA 1Laboratory: Preanesthetic unremarkable, see attachedAlbumin 40 H (reference range 20-39)ALP 10 L (reference range 23-212).Rest all WNLTreatment: Premed: Methadone 0.45 mL IV at 12:25PMInduction: Alfaxalone 2 mL IV at 01:28Intubated with size 6.5 cuffed ET tube and maintained iso 1%/oxygen 1 L/minIVFT started Hartmans 58 ml/hrEars:  CleanTeeth: Full mouth X-rays done.Nails: ClippedSurgery started: 01:30Technique: Planned extraction 208 only. Wide based mucoperiosteal flap elevated. 208 crown fracture involving buccal aspect of crown and some of rostral and buccal root. Lingual aspect of root also partially fractured. Individual roots removed and confirmed all roots removed. Closed with Monosyn 4/0 simple interrupted. Good apposition. Rest of teeth scaled and polished.Surgery finished: 02:30Anaesthesia finished: 02:30Recovery: goodPain relief: Meloxicam 0.23 mL SQ at 03:00Plan: Home with Meloxicam 1 mg SID PO from tomorrow morning and Amoxyclav 250 mg 3/4 tablet BID PO. Soft foods only until recheck.F/U call tomorrow.Suture removal in 10-14 days.    Vital Signs    

Appointment Notes: dental check, slab fracture.  *JAC's family friend* Subjective: Approx 8yo. UTD with vx, parasite control.  Os brush her teeth at home.  Noticed a fractured tooth with swelling around the L side maxilla a little while ago. Swelling has since reduced. No discharge from the gums.   Still seems more comfortable. Still eating well.   No issues chewing. Is on mostly on dry kibble. Some wet. No vomiting or diarrhoea. No current meds. Other vet: Walkerville Vets.   No medical hx to note. Objective: BAR  HR/PR/Cardio: 108, normokinetic, no obvious murmur or arrhythmia   Temp:  38.2   MM/CRT/Hydration: pink, moist <2s   RESP: clear, normal bronchovesicular sounds   GIT/UG: comfortable with abdominal palpation, unremarkable   Skin/Ears: Clean coat, well groomed. Ears free from discharge on external exam of the internal pinnae.   M/S: ambulating fine   Eyes: clean and bright  Dental: mostly clean but mild build up over the upper canines. Slap fracture (flap of tooth still present overlying the exposed pulp) of 208. Moderate gingivitis around this area. No maxillary or mandibular swelling. Lymph Nodes: wnl   BCS: 6/9 Assessment:  Slab F# of 208.  Risk of TRA. Treatment: nil for now Plan: Discussed dental procedure, typically 2 stage procedure but in this case would rcc'd SPA and 208 ext same day. If other extractions required, then will return for a 2nd procedure for extractions. Estimate provided to O. Has insurance, will get pre-approval. Booked in 2w time when Os return from holiday. Advised if noticing swelling/pus then start abx pre-operatively. Okay for 187.5mg noroclav PO BID for 5-7d.      Vital Signs    Weight: 11.4;