C09994741 / invoice 10000

Reason: Bandage Change/ Check FootAppointment Notes: Overdue remindersBandage removal - malodorous, small piece of mobile tissue, painful to touch. Recommend sedation and clean and debride loose piece. BAR. Mms pink and moist, CRT 1.5s No murmur or arrhythmia HR 124. RR 40 normal effort and lung sounds. Sedation 10ug/kg medetomidine and 0.3mg/kg methadone. Top up alfaxan 1.8ml IV.Chlorhexidine soaked affected toe scalpel used to sharp debride away tissue fragment - tiny tip on bone in tissue. Dew claw swelling. Tiny lifted nail fragment on lateral nailbed - removed with hemostats.  Remaining nail fixed in place and left. Chlorhex soaked again then flushed with sterile saline. Dressed with melolin, sofban, conforming gauze, elastoplast and protective layer of vetwrap. PLAN: 250mg amoxyclav Po BId0.1mg/kg meloxicam PO SID - 5dLeave in place 1 week.    Vital Signs    Weight: 12.1;       

Reason: Dew Claw Hanging Off - Bleeding Appointment Notes: Overdue remindersPresented for torn dew claw.  Happened a few days ago, O had appointment for tomorrow however on walk today was limping and started bleeding.No health problems, not on any medicationsExam:Torn LF dew claw - angling medially, not actively bleeding at time of examTreatment:Pulled torn dew claw - unable to remove entirely, small amount of nail still embedded cranially, small amount of bleeding following removalPlan:Bandage and keep cleanRe-check Friday: remove bandage and re-assessExplained to O that sometimes depending on how nail is growing that may need to remove remaining nail under heavy sedation.  Have scheduled surgery time for Gator on Friday in-case required.O to bring in fasted    Vital Signs