C10007228 / invoice 10000

Has had 100mg gaba pre appt. Will likely try bite when u look at the foot get O to hold
Under pinky toe is red L front paw. constant licking
Sedate and investigate? 
At cammeray had convienia and melox

History:
- 2 weeks ago, he fell off car seat and was limping 
- went to cammeray, they gave him meloxicam and convenia inj
- helped for a little bit but now constantly licking at LFL
- very anxious dog in general 

Physical Examination:
BAR, temp:  not taken 
BCS - 5/9
Lymph nodes: normal
Mouth - dental disease grade 2, mucous membranes: pink, Crt <2sec
Ears - no abnormalities
Eyes - conjunctiva and orbit normal
Skin and coat - normal
Chest - thoracic auscultation normal, HR: 120
Abdomen - all abdominal viscera palpate normally
Limbs - no lameness detected. very long nails, nail bed looks OK no obvious infection 

Differential Diagnosis:
broken nail vs fracture vs osteomyelitis vs neoplasia vs anxiety

Diagnosis:
broken nail vs anxiety 

Plan: 
- disc with o to do xrays to rule out fracture/osteomyelitis vs trial anti-lick to stop behviour
- o opted to do antilick first then INI xrays next monday

HX re P5

Dispense chill protocol for clinic visit - reported to be "bitey"

gabapentin 100mg 1 cap PO 1-2 hrs prior to clinic visit. 
assess repsonse at cv - may need to add in trazodone for next visits if considered insufficient effect