C10015434 / invoice 10000

11/03/2026 
HISTORY: Ava has  broken the nail on her LF dew claw, she has been licking it a lot. Ava is deaf. O mentions some intermittent incontinence, but does not think that Ava is PU/PD. 

CLINICAL EXAM:
Demeanor: BAR
Ears: NAD
Eyes: NAD - clear
Nose: NAD - no discharge or changes
Oral cavity: mm- pink & moist
Lymph Nodes: NAD
Cardio-respiratory:HR= 130 BPM, no murmur, heart sounds regular, lungs clear
Abdomen: NAD - no pain or abnormalities on palpation
Skin: broken nail on LF dew claw. Painful to touch
Musculoskeletal: gait normal
BCS: 5/9
Temp: 38.2

Ddx: Traumatic nail injury, poss secondary infection

PLAN:
- Sedate and administer local anaesthesia to trim the broken nail. Advised bloods dt age, but O declined
- Apply a bandage to be left on for 2-3 days. Advised e-collar, but O declined and said she would not keep it on.
- Start antibiotics tonight and maintenance dose of Nsaids for 5 days.
- PO check 3-5 days

Gave 0.003mg/kg(0.08ml) medetomidine inj sc and 0.2mg/kg (0.5ml) methadone inj im. Acceptable sedation achieved for iv cannula placement.
Placed iv cannula in R cephalic
Gave 1.5 ml alfaxalone iv. Did ringblock around nailbed with 0.5ml lignocaine
Cut nail of near nailbed. Stemmed bleeding with potassium permanganate
Placed bandage with melolin dressing, sofban, vetwrap and elastoplast to anchor it on the fur, so hopefully lasts longer
Bandage off in 3-5 days. Must be kept dry- bootie provided.


TREATMENT:
- 600 mg cephalexin po bid for 5 days- start tonight
- 0.5ml meloxicam inj sc
- 1.5ml meloxicam oral po sid with food to start tomorrow afternoon for 4 days

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