C09987605 / invoice 10000

WEIGHT: 18.30
HEART: 140
DIAG: Laceration to the RIGHT  side of the tongue 
+/- sublingual nerve inflammation/tear. 
Unable to swallow post op
TREATMENT: Methadone 0.38ml on recovery 
meloxicam 0.35ml sc 
paracetamol 10mg/kg 3ml bid for 3 days 
PLAN: See tomorrow. if still not drinking.
DENTAL: 0
BLDRQ: N
CLIN_EXAM: Very timid, nervous. 
Able to look in the mouth. 
premed:medetomidine 10microgram/kg (0.18ml ) / butorphanol 0.2ml 
good sedation 
ind: propofol slow iv 
Suction a lot of blood from the back of the throat. Tear to the Right side of the tongue just lateral to the sublingual artery. Flushed with saline - removed numerous small splinters. The laceration of 4cm reached into the sublingual area. 
closed with 5-0 wego continuous suture. Wound extended to the point of the jaw.
WRMRQ: N
HISTORY: Brought straight in from the park with stick injury 
bleeding from the mouth 
Ate 1230pm
FLRQ: N
BODY: 7

HEART: 130
WEIGHT: 16.4
HISTORY: Owned by x partner 
Front claws  long
Fractured nails in the past
BODY: 7
FLRQ: Y
WRMRQ: Y
CLIN_EXAM: mm pink, unable to examine 
hr 140 clear
TREATMENT: gabapentin 300mg 2 hours prior + trazadne 100mg 1 2 hours prior 
Able to clip front nails on return visit with slow approach, support from owner
Lateral R nail (RFL V) elevated from bed, may require sedate and remove if still catching/irritated despite clipping today
DIAG: timid ---
COMMENTS: Showed owner "teaching your dog to use a scratch pad" youtube video - trial for ongoing nail care