C09981791 / invoice 10000

Reason:  Solensia + recheck paw
History: 
- Has not been bothered by the paw, O only initially noticed the risen nail during a nail clip
- Stopped giving clavulox after 10 days because P had loose stools, V+, foaming at the mouth, and was refusing to take the medication
- O has given probiotics (prokolin, yogurt) to repopulate gut biota
- Stools have firmed up. Did have a "soft-serve" consistency the other day
- O notes good activity on solensia injections

Current medications: 
- Gabapentin given 2hrs prior to vet visit
- Clavulox stopped (loose stools, refusing to take, frothing at mouth)

Examine: 
Mentation: BAR
Body condition score: 4/9
MM: pink, moist               CRT:   1s
HR:  130bpm              RR: 24bpm
LN: nsf
Temperature: nt 

Ocular: nsf
Oral/Dental stage: nad
Ears: nsf
Cardiovascular: no murmur/arrythmia auscultated today
Respiratory: normal BV sounds
Gastrointestinal: comfortable on abdo palp
Integumentary & lumps (measurement, location):
- LH 3rd digit nail slightly raised off nail bed, no erythema/discharge/swelling
Musculoskeletal: ROM nsf

Problem List:
1. Nail bed infection resolved

Assessment: 
Fit for solensia injection

Treatment: 
Solensia injection SC
- Batch no: 822303, EXP07/27

Plan: 
Rescript for solensia injections every 4 weeks

Spoke with Marina, if paw is okay, stop meds. If redness and swelling come back another consult 
O has another appt for Solesia with vet on 03/03 next week to check -mcb 

O called on 25/02

Reason: Courtesy phone call 
Nurse: Marlene 
History:  infected nail 
     Demeanour: BAR
     Eating/ Drinking: normal 
     Toileting: normal, loose stool
     Any concerns? struggling with meds, drooling post meds, generally refusing now (even with high value treat) 
     
Treatment:
     Medications being given: Clav, 
     Patient taking meds as prescribed? not really taking it well, mixed it with food 

Assessment: left a note with vets on 26/02, nail looks pretty good atm, no more redness 

Next Appointment: