C09997983 / invoice 10000

Appointment Notes: Vaccination, nail trim + check front paws has been licking / yelped when O went to touch last night -MJHS painful paw right forepaw since yesterday O all ok suspect torn nail right forelimb - ok for vaccination neede to admit for examGA: WAC - dom/torb 0.89/0.36mL IM at 3:05pm, good sedationProcedure: The RFL D5 nail is splintered with exposed quick, looks like older injury and there is superficial abrasion/lick trauma over MtC/P1 region, clipped and cleaned. Trimmed nail back to tidy up.The D4 nail is long and a little irregular/curved (possible early onychodystrophy?) but also query prev trauma with irregular nail growth? All remaining nails on the paw and other 3 paws are normal but long - trimmed sharp tips.Also found numerous matts and burrs/grass seeds in coat so groomed and clipped out heavy matting behind ears, in groin, axillae and caudal legs and tail. Nothing in other paws.EO has advised client to postpone vaccination todayRx: Home with metacam and cephalexin and review for vacc in 7-10dClient Communication: 4:05pm - updated ms on findings, damaged nail that looks older injury with infection now, should settle with meds - review 7-10d for vacc, he was out on farm day wed hence the matting/burrs in coat, booked d/c with nurse after 5pm    Vital Signs    Weight: 35.5;       

O called to ask what she should do for ears if she thinks ear infection. I said if ear infection would need consult and medicated drops - vet would run a cytology sample to see which drops best, would only know by examining dog. If just waxy ears could try with ear cleaner first. But if she thinks ear infection then I we have appts today and could fit him in. I asked if head shaking, smelly ears. She said ears are waxy with just a bit of discharge, but not smelly at all, not bothering him, no head shaking. Said she recently cleaned out quite a large wad of hair from the ears too so she will try to use a cleaner first and call us back if no improvement or she thinks it developsMAG     Vital Signs    

owner rang wanting to pick up the neocort cream as EO notes says they can if not improving.    Vital Signs