C10011741 / invoice 10000

Damaged dew claw

History:
Been throwing the ball, ripped front dew claw. Happened 1 hour ago. Has happened 2-3 times before. 
Not bleeding. Wont let O touch it. 
EDDU normal V-D- 
FTW & Vx: utd 
Current meds: nil 

Physical exam - brief, very skiddish 
BAR, nervous HR100 bpm RR60bpm MM p&m CRT<2s BCS5/9 Tnp - did not tolerate 
Cardiac: no murmur , normal rhythm and intensity 
Respiratory: normal bronchovesicular sounds on thoracic auscl. 
EENT: eyes clear bilat. 
Integument: clean coat, nil parasites evident. matting behind ears. LFL dew claw pulled 
Oral:C1G0 
Peripheral lymph nodes: submandibular, prescap, popliteal  wnl
Abdo palpation: tense on palpation 
MSK: Normal gait. Normal rom. Full MSK exam not performed
Neuro: normal mentation. Full neuro exam not performed. 
Rectal: NP
Hydration: no skin tent, mm moist 

Assessment: 
Pulled nail - dew claw LFL 


Treatment: 
Sedated with methadone 0.3mg/kg (0.5ml) and medetomidine 10mcg/kg (0.2ml) IM 

Topped up with 20mcg/kg (0.4ml) IM 

Sprayed dew claw with intubeaze (lignocaine)
Pulled nail 
Clipped fur around dew claw. Cleaned with dilute iodine.

Bandage applied: melolin over nail > soffban > conforming > vetwrap > elastoplast at top 

Reversed 0.6ml antipam IM
Quick recovery 

Moxylan 2ml sq 
Meloxicam 0.8ml sq 

Meloxicam tgh SID PO 
Amoxyclav 250mg BID po 

Plan: 
O has E collar at home 
Keep clean and dry 
Remove bandage in 3d 

O cancelled due to ill health, has sent through pictures. looking good.

dew nail appears to be healing well, have left bandage off today to allow breathability, set up with new cone as last he broke last one, advised o to use sock with elastoplast as a last resort if he breaks out of cone again. revisit in 3 days cs