C09974897 / invoice 10000

02/03/2026 
NURSE: EL

REASON: Recheck of a damaged nail, which is now growing into the adjacent pad. Also presenting with diarrhoea for the past four days.

HISTORY:
The nail issue has been present for a few weeks. The owner reports a hard stub is present and the patient continues to lick the area. The diarrhoea has been present for four days, occurring twice daily, with no visible blood.
Previous nail injury treated with a 3-day course of antibiotics post-incident. No known allergies or adverse reactions to previous antibiotics.
Potential for scavenging as the patient has free-roaming time in a paddock with numerous dead rabbits and crows.
Currently fed chicken and rice or chicken and pasta.
Has free-roaming time in a paddock.

APPETITE: Eating normally, hungry.
ACTIVITY: Normal energy levels.
DIET: Chicken and rice or chicken and pasta.
TOILETING: Diarrhoea twice daily for four days, no visible blood.
CURRENT MEDICATIONS: Nil.

CLINICAL EXAMINATION:
Mentation: BAR
MM: pink, moist MMs, CRT <2s
Oral and Dental Score: Not assessed
Eyes: Clear. Pupils are equal and responsive.
Ears: externally clean
BCS: 5/9
Lumps: none found
Abdominal: tense. unremarkable 
Lymph nodes:  wnl
MSK: Swelling of the entire toe on the left forelimb. There is pinkness and a hard stub where the nail was. A gap is visible at the side of the emerging nail. Suspected exposed quick, with a possible fracture off the end of the bone.
Skin: wnl

ASSESSMENT:
A suspected nail bed infection of the left forelimb has been identified. The toe is swollen. A new nail appears to be emerging, but the quick may have been broken off during the initial trauma.
The diarrhoea is suspected to be due to dietary indiscretion, possibly from scavenging.
Suspected nail bed infection of the left forelimb. The toe is swollen. A new nail appears to be emerging, but the quick may have been broken off during the initial trauma.
Suspected dietary indiscretion, possibly from scavenging.

DISCUSSION:
Discussed the administration of Pro-Kolin paste using the dial-a-dose syringe. Advised on monitoring for improvement in the affected toe. Explained the plan for further diagnostics, including X-ray and deep swabs for culture under sedation, if improvement is not seen.

TREATMENT:
Amoxiclav 500mg, one tablet twice daily for two weeks.
Pro-Kolin paste, 7mL twice daily for two days.
Continue chicken and rice diet for another 48 hours.

PLAN:
Re-evaluation in two weeks. Advised to return in one week if there is no improvement, as this would indicate the need for further investigation. Signs of improvement would include reduced swelling, pain, and licking.
X-ray and deep swabs for culture may be considered if there is no improvement with the current treatment plan.
Collect a faecal sample if the diarrhoea does not resolve within 48 hours.