╨╧рб▒с>■  ,.■   +                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴ ┐рjbjbjкjк $╚╚р       ]вввввввццццц Є цъ        <>>>>>>,iЇ] Аjв     j║вв   ║║║ Вв в <╢╬вввв <║В║<вв<■ мКэ╢ццМ.<Client education: In terms of the bloodwork done, although there were abnormalities, the client can be informed that these are not severe enough to be of concern. They can be expected considering the trauma and subsequent treatments/supportive care (i.e. fluids, steroids). There did not seem to be any evidence of significant organ damage. The client should be instructed to confine the patient to a cage or room for a week, only walking the dog to allow it to defecate and urinate. After this initial period, controlled leash walking can be started. Exercise should be limited to this and the dog should be prevented from playing with other dogs over the next five weeks. The clients should bring in the patient for recheck radiographs at approximately 6 weeks post-op at which point plate/pin placements, alignment, and healing process can be evaluated. If the client opted for external fixation of the tibia, they must also be instructed on the proper care of the pins and sidebars. The pin tracts should be cleaned daily with a gentle garden hose or kitchen faucet spray. The tracts can then be dried with a towel or hair dryer on a cool setting. If the client sees excessive drainage from the tracts, the dog should be brought in for radiographs as this usually indicates pin loosening. If the patient begins chewing on the side bars, he should also be brought in. This behavior usually indicates pain and/or irritation from pin loosening or fracture instability. Damage to items in the house is a definite possibility that the client needs to be aware of. For this reason, the patient should probably be confined when alone and potential problem areas/items should be padded. At post-op radiographic recheck if there is no evidence of bone resorption around any of the screws or pins, of visible fracture lines, or of bony lysis, and the implants are all stable, the external fixation frame, if used, can be dismantled. At this point, the owners should restrict exercise for another week or two and then the patient may be returned to normal activity level. The plate(s) do not need to be removed unless associated with problems such as drainage, infection, pain, and/or mechanical interference. The dog will be sent home wearing a Fentanyl patch for analgesia and prescribed a course of anti-inflammatory medication such as Etogesic or Rimadyl. The client needs to be informed about the nature of the drug (morphine like effects) being delivered by the patch. They should not remove it or handle it. They need to come back in for removal of the Fentanyl patch in 3 days. After which, the patient can be sent home and should be monitored for signs of pain, as well as given the anti-inflammatory agent for the prescribed course of time. The owner will be advised to monitor the animal for normal urine output and defecation. As a side note, the owner should be reminded of the importance of heartworm prevention and the distemper and rabies booster. NOTE: If the conservative treatment option (splinting) was chosen for either leg, the patient needs to be cage/room confined for 6 weeks post-op. Each week the client must come in for band readjustments. Radiographs need to be taken and evaluated as mentioned above at 6 weeks post-op. If positive signs of healing are present on radiographs, the splint can be removed and the dog can be gradually be returned to activity. This process should be taken slowly in that the prolonged immobilization may have caused joint stiffness and muscle weakness/atrophy. рXbд ▒ ╒лмнр¤¤∙¤¤∙∙∙∙¤Д╨ ▄·√№Xbд ▒ ╒лмнр■■■■■░╨/ ░р=!░"░#Ра$Ра%░ [4@ё 4NormalCJOJPJQJmH <A@Є б<Default Paragraph Fontр $           N р Тррр#,√ хя8=╒▌2 : > E   p y ┌ у т @IЙНК У т    Math Emporium>Macintosh HD:Desktop Folder:Student's Folder:11.ClientEd_a.txt Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math EmporiumLMacintosh HD:Desktop Folder:Student's Folder:AutoRecovery save of 11.cliente Math Emporium@Macintosh HD:Desktop Folder:Student's Folder:text:4client _a.txt @А√√м ╕√·"cр а@GРTimes New Roman5РАSymbol3Р Arial3РTimes"qИ╨ho To Tq !е└┤┤А20 ╨  Client education: Math Emporium Math Emporium■  рЕЯЄ∙OhлС+'│┘0pИРм╕╨▄ь  , 8 DPX`h'Client education:dlieMath EmporiumonathNormalpMath Emporiumon2thMicrosoft Word 8.0d@^╨▓@B╙╬╗└@B╙╬╗└q ■  ╒═╒Ь.УЧ+,∙о0 hpИРШа и░╕└ ╚ ц'Virginia Techa м Client education: Title ■   ■    !"■   $%&'()*■   ¤   -■   ■   ■                                                                                                                                                                                                                                                                                                                                   Root Entry         └F╛Vї║└/А1Table            WordDocument        $SummaryInformation(    DocumentSummaryInformation8            #CompObj    XObjectPool            ╛Vї║└╛Vї║└            ■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           ■      └FMicrosoft Word Document■   NB6WWord.Document.8