C10013505 / invoice 10000

Reason: Cut Nail Very ShortHISTORY:Rain, an 8-month-old entire puppy, presented for active, pulsing haemorrhage from the left front digit V after the owner trimmed the nail too short. Otherwise, EDDU normal and no other health concerns. Last ate 2 hours ago + treats in the consult room. EXAMINATION:Body Condition Score: 4/9Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:- Oral: normal, no mouth pain, dental score (1-4): 0- Abdominal: no detectable pain on abdominal palpation- Rectal: NAD.Urinary: No obvious discharge or lesion superficiallyReproductive: No obvious discharge or lesion superficially. Both testicles descended. *****Integument/Ears: haemorrhage from left front digit V nail bedLymph Nodes: Peripheral LN's WNLEyes: Clear and no discharge presentDemeanour/Behaviour: BAR. Very active puppy. ASSESSMENT:PROBLEM LIST:- Active haemorrhage, left front digit V DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Traumatic nail trim resulting in exposure of the quick.TREATMENT:- Methadone 0.2mg/kg IMMeds/Product Dispensed: Gabapentin 400mg PO BID PROCEDURE:Pressure bandage applied LFL swab/sofban/riprap - blood leaked through - added bandage with swabs for pressure/monitor blood loss.  2nd wrap had leaked amount through about 8 swabs, removed and added another bandage with swabs - this one did not have and leak through on checking.  Added one more to go home with, asked o to monitor and if leaks through would require sedation and cautery. PLAN:If haemorrhage persists, the plan is to proceed with sedation and cauterization of the nail bed. Home into owner's care for monitoring. O was given option to sedate and cauterise tonight; o opted to take home with bandage and remove tomorrow. Advised to return to clinic to remove bandage under supervision to see if bleeding begins again. O will likely come to AEC to have it removed.--- 11/03/2026 08:12:22 AM EQM:Treatment - Resolved - text & hx sent - em    Vital Signs    Weight: 26.5;       HeartRate: 134;       DentalGrade: 0;       RespirationRate: Pant;       Temperature: 39.3;       CRT: 1-2sec;       MMColour: P+M;       BodyScore: 4;