Pages

Sunday, February 19, 2012

Montana's Final Bill



Montana, I have been thinking a lot about you.  Well....I think about you every day but it seems like most of my day is consumed with my thought of you.  After 5 1/5 mos I finally had the nerve to look at the bill from the emergency vet.  It spelled out everything.  More then I really wanted to see.  Of course I sobbed when I read it. This is what it said:

CLIENT INFORMATION

Beth Winchell

PATIENT INFORMATION

Name:  Montana                                 Species:         Canine
Sex:     Male, Neutered                       Breed:           Siberian Husky
Deceased:   09-05-11                         Age:              D@9y
ID                                                       Rabies
Color:   Black and White                   Weight           102.20lbs
Reminded:  (none)                             Codes:           D

MEDICAL HISTORY

Date              By              Code            Description               Qty (Variance)
____________________________________________________________

09-05-11      JH             001         Emergency Exam Fee

    Age:  9y     Weight:  102.20   Temp:  106.00     Pulse  180.00
    Other:  mm - pale pink

SUBJECTIVE SECTION

Surgery to amputate tail last Wednesday.  Has not eaten since.  Was on Deramaxx and Tramadol.  Vomiting dark brown fluid.  Tonight panting, weak, lethargic.  Dr. Harper on duty.

OBJECTIVE SECTION

mm- pale pink, pulses thready.  Chest - tachycardia, heart muffled.  Abd - distended.  Laterally recumbant, panting, very weak.  Febrile.

ASSESSMENT SECTION

               RULE - OUTS
               Gastroduodenal Ulcer Disease                  


              DIAGNOSES
              Sepsis and Bacteremia
              Septic Shock
              Acute Abdomen

PLAN SECTION

            NOTES

                 I-Stat EC8+- See report; metabolic acidosis
                 Oxygen 5LPM via mask
                 IV placed, bolus 2L Norm-R, 300ml Hetastarch IV; pulses improved,                                   HR decreased
                 U/S FAST - large amount of free fluid in abdomen - 1L of brown pus
                 removed via abdominocentesis          
                 Cell counts - WBC 78K, TS - 3.8; cytology degenerate neutrophils and
                 pleomorphic bacteria.  BG of fluid 45,  Diagnosis - septic abdomen
                 (perforating ulcer?), septic shock
                Discussed poor prognosis with owner, the need for immediate
                surgery 
                and the risks associated.
                Owner requested euthanasia
                Euthasol 15mg IV

                          1005             Informed Consent
                          HETA          Hetastarch (HES) 6%                 300
                          NORMR      Normosol -R 1000ml
                          611              IV Extension Set
                          601              IV Catheter & 1st Bag Fluids
                          EFFUSION Automated Cell Counts - Effusions
                          GLUCOME Blood Glucose - Glucometer
                          420              I-Stat EC8+
                          USFAST     Ultrasound F.A.S.T. Exam
                          117             Abdominocentesis
                          OXY5         Oxygen per minute @ 5 lpm          15
                          ACUTEAB Acute Abdomen
                          D1016         Septic Shock
                          D6058         Sepsis and Bacteremia
                          1112           Euthanasia
                          EUTH         Euthasol 390mg/ml                       15
                          1110           Ashes Returned:  100-140# 


FOR:  Beth Winchell                                             Printed:  09-05-11 at 4:25am
                                                                                Date:      09-05-11
                                                                                Account: 34720
                                                   
                                                                                Invoice:  62944


Date              For                  Qty      Description                              Net Price
 _____________________________________________________________

09-05-11      Montana              1   Emergency Exam Fee                        82.00
09-09-11                                  1  Informed Consent                                0.00
09-05-11                              300  Hetastarch (HES) 6%                        69.00
09-05-11                                  1  Normosol-R 1000ml                         38.00
09-05-11                                  1  IV ExtensionSet                                 16.00
09-05-11                                  1  IV Catheter & 1st Bag Fluids             86.00
09-05-11                                  1  Automated Cell Counts - Effusions    50.50 
09-05-11                                  1  Blood Glucose - Glucometer             12.50
09-05-11                                  1  I-Stat EC8+                                        53.55
09-05-11                                  1 Ultrasound F.A.S.T. Exam                  92.00
09-05-11                                  1  Abdominocentisis                              60.00
09-05-11                                 15 Oxygen per minute @5 lpm                 2.25
09-05-11                                  1  Euthanasia                                          55.00
09-05-11
                        We are truly very sorry for your loss

09-05-11                                15  Euthasol 390mg/ml                            20.40
09-05-11                                 1  Ashes Returned 100-140#                 250.00

09-05-11                                Care Credit                                           -887.20

-----------------------------------------------------------------------------------------
Old Balance           Charges        Payments                             New balance
        0.00                   887.20           887.20                                           0.00

















No comments:

Post a Comment