C09974900 / invoice 10000

Reason: cut paw or torn nail History: O woke up this morning to let out dogs noticed Lilly foot was bleeding everywhere & she wasnt weight bearing on foot. O tried to look but difficult due to blood & pain. Possibly saw cut on paw pad. Otherwise before hand all EUDD, no other meds/sup Assessment: Tried to examine whilst awake very wriggly & painful, appeared to be possible broken nail Admitted for sedation to examine food then treatment Whilst sedated noticed ears waxy on pinna, otoscope ok can see TM intactMicroscopy of ears no pathogens hence no tx neededMM P & M, G2-3/4 dental disease Laboratory: PCV: 48TP 82BG 6.5Rest WNL Treatment: Sedation methadone 0.18ml & medetomidine 0.18ml - mod sedation but not deep enough 22g IV catheter placed in R cephalic vein Alfaxalone small bolus top ups to maintain sedation Shaved LFL, 4th digit nail mostly off at base small amount attached still Lignocaine spray on nail, then removed with Hemostat. Cleaned area with chlorhex & another lignocaine spray Applied bandage to cover nail bed. GS found in between digits LHL & underneath foot, some just started poking into skin. All feet checked. Matts between paw pads on FL shaved out Nails trimmed & carflexin 0.72ml SC O called: AG spoke to O let know results above, including ear check & GS found. Discussed can do regular nurse nail trims as needed to help keep shorter Plan: bandage left on 2-3 days, E collar as needed. POC in 2-3 days Noroclav 0.5BID until finished start tonight Carflexin 0.5BIDF start tomorrow    Vital Signs    Weight: 9;