C10007764 / invoice 10000

Appointment Notes: VETSTORIA - Paul Curyer (0433800168 emery.meg@gmail.com) with Nellie (Dog) - Consultation (Discuss desexing and X-ray for leg operation. Also she is scraping her nails as she walks on her operated leg.) No, this is not for a day procedure.  [Veterinarian : Dr. David Fowler(No Preference)] Web BookingClient name: Paul CuryerContact number: 0433800168Email address: emery.meg@gmail.comPatient name: NellieHistory:Presented to discuss LEFT forelimb function.LEFT pancarpal arthrodesis in Sept 2025.Had last set of rads in Nov 2025 - follow up rads were recommended 4-8 weeks later, but did not occur.She uses the LEFT forelimb apparently comfortably with no detectable sign of pain.Walked outside - she does have a LFL limp >>> DF suspects could be a functional/mechanical limp given there is no flexion in the carpus.Paul's concern > digits 3 and 4 (central digits) tend to drag on the ground (audible on concrete and leaves lines in the sand when walking on beach). Consequently the naisl are short/worn close to the quicks - wonders if there is discomfor or potential discomfort in the future, associated with this.He asked if we can "de-claw" the central 2 x toes.Explained that to do this, removal of the associated P3 is needed (partial digit amputation, effectively).I often find that if leave P2 or P1 in-situ, the stumps tend to get knocked and I think I better outcome is total digit amputation (from P1 inclusive, distally)............And in this case, 2 x digits....The question now is, is this truly justified.If we are desexing soon (we should be ASAP as had first heat approx 6 months ago), it's an opportunity to do other surgery she might need. However I think the risk of future problems is low and we should ideally NOT be doing this surgery at this time.Suggested we consider a "bootie" when walking on concrete to protect the nails from friction > Paul will look into this.For now, no plans for Sx besides desexing.Will book for desexing soon.OTHER: Discussed 50% ration cutback - weight loss needed for long term best mobility and general health.DF    Vital Signs    Weight: 32.3;