Species: dog
Breed: crossbreed
Sex: male, not neutered
Weight: 12.4 kg
Birth date: 2008-10-16 00:00:00
Primary diagnosis: Mucocele of the gallbladder
Situation: Post-surgery
Time since surgery: > 12 hrs
Recovered from anesthesia: No sedation (0)
Medical history: Jimmy has vomited 8 times since yesterday morning, showing apathy and anorexia. The vomiting (really with abdominal press) was a food like substance in large quantity. Then the 7 other times it was liquid (beige, foamy). He has urinated 4 times in the house because he is too tired to move more. The owner went to the PTA this morning and Jimmy was given an infusion subcutaneously + an injection of painkiller and an injection for nausea. Since then he has not vomited but the PTA does not know exactly what he can do so the owner has come to have an explanation. He is well vaccinated these last years and he is dewormed regularly. Previous illnesses: Cardiomyopathy which is under therapy (2 times daily 2,5mg of Pimobendan)
Medication: On 1.10.2024 : Pimobendan 2.5 mg (0.2 mg/kg) PO BID, methadone 0.1 mg/kg IV q4h, Ondansetron 0.3mg/kg IV TID N-Acetylcystein 70mg/kg IV TID. On 02.10.2024 : *Methadon 0.1mg/kg IV q4h *Ondansetron 0.3mg/kg IV TID *N-Acetylcystein 70mg/kg IV TID *Ophtalmic ointment both eyes q4h *Pimobendan 2.5mg PO BID *Ampicillin-Sulbactam 30mg/kg IV TID. On 03.10.2024 : *Buprenorphine 0.015mg/kg IV TID *Ondansetron 0.3mg/kg IV TID *N-Acetylcystein 70mg/kg IV TID *Ophtalmic ointment in both eyes q4h *Pimobendan 2.5mg PO BID *Ampicillin-Sulbactam 30mg/kg IV TID. On 04.10.2024 : *Ondansetron 0.3mg/kg IV TID *N-Acetylcystein 70mg/kg IV TID *Ophtalmic ointment in both eyes q4h *Pimobendan 2.5mg PO BID *Mirtazapin 0.5mg/kg PO SID On 07.10.2024 : *Ondansetron 0.3mg/kg IV TID *N-Acetylcystein 70mg/kg IV TID *Ophtalmic ointment in both eyes q4h *Pimobendan 2.5mg PO BID *Mirtazapin 0.5mg/kg PO SID * NEU Sondenfütterung 33% RER * MCP CRI 1mg/kg/t * Paracetamol 10mg/kg IV TID * Methadon 0.2mg/kg IV q4h * Amlodipin 0.05mg/kg PO SID. On 08.10.2024 : * Ondansetron 0.3mg/kg IV TID * N-Acetylcystein 70mg/kg IV TID *Ophtalmic ointment in both eyes q4h * Pimobendan 2.5mg PO BID * Tramadol 4mg/kg PO TID * Mirtazapin 0.5mg/kg PO SID * MCP CRI 1mg/kg/d * Paracetamol 10mg/kg IV TID * Amlodipin 0.05mg/kg PO SID On 09.10.2024 : * Ondansetron 0.3mg/kg PO TID * N-Acetylcystein 70mg/kg PO TID *Ophtalmic ointment in both eyes q4h * Pimobendan 2.5mg PO BID * Tramadol 4mg/kg PO TID * Mirtazapin 0.5mg/kg PO SID * MCP 0.3mg/kg PO * Paracetamol 10mg/kg IV TID * Amlodipin 0.05mg/kg PO SID
Anesthesia: Intervention on 01.10.2024 : explorative laparotomy and placement of an oesophageal tube. Premedication at 14:45 : methadone 0.2 mg/kg IV and lidocaine 2 mg/kg IV. Induction with midazolam 0.2mg/kg IV, ketamine 4 mg/kg IV and propofol 1mg/kg IV. Maintenance : FiO2 and sevoflurane. Analgesia: bolus methadon 0.2 mg/kg IV, IV infusion of lidocaine 1.8 mg/kg/hr for 210 minutes, bilateral QLB block with Ropivacain 2.9 mg/kg/hr (dexmedetomidine 6 mcgr added to ropivacaine). Complication : hypotension, was given a RA bolus 10 ml/kg and Noradrenaline 0.15 mg/kg. Antibiotics : ampicillin/sulbactam 30 mg/kg IV. Wake-up phase : post op sedation : acepromazine 0.005 mg/kg IV and for analgesia : bolus methadone 0.2 mg/kg IV. Duration of intervention 150 minutes. Duration of anesthesia : 245 minutes.
Pain type: acute, nociceptive, inflammatory, somatic
Pain origin: abdomen
Pain duration: More than 7 days
Estimated pain severity: 5