C10015736 / invoice 10000

Reviewer

Species:CANINE

Breed:Cavalier King Charles Spaniel

Age (years):8

Diagnosis or signs:Nurse appointment

Consult notes

11/03/2026 Hx:
left forelimb dew claw curenled into toe, purrulent discharge and sig swelling. 

PHYSICAL EXAM: 
Attitude: BAR, FAS
BCS: 3/5
Heart/lungs: heart murmur 
MM: pink and moist
Skin Tent: normal
Dental Score: 2-3
Abdomen: nad
Skin: normal
Eyes:nad
Ears: nad
Temp: not assessed
Lymph Nodes: normal
MSK/Neuro: 4x ambulatory
Rectal: not assessed

ASSESSMENT: infected toe from nail grown into pad

PLAN: nail clipped and cleaned with chlorhex. Matisse flailing and trying to bite (muzzled).  Had PVP but last dispensed in 2024 - out of date opssibhly? or possible higher dose needed. 
antibiotics.
recomend a dental + heart size rad. SE

Animal clinical history (3 most recent)

2026-03-11T00:00:00Z 14:09:45

Hx:
left forelimb dew claw curenled into toe, purrulent discharge and sig swelling. 

PHYSICAL EXAM: 
Attitude: BAR, FAS
BCS: 3/5
Heart/lungs: heart murmur 
MM: pink and moist
Skin Tent: normal
Dental Score: 2-3
Abdomen: nad
Skin: normal
Eyes:nad
Ears: nad
Temp: not assessed
Lymph Nodes: normal
MSK/Neuro: 4x ambulatory
Rectal: not assessed

ASSESSMENT: infected toe from nail grown into pad

PLAN: nail clipped and cleaned with chlorhex. Matisse flailing and trying to bite (muzzled).  Had PVP but last dispensed in 2024 - out of date opssibhly? or possible higher dose needed. 
antibiotics.
recomend a dental + heart size rad. SE

2025-03-29T00:00:00Z 11:26:14

Matisse presented for a nail trim today.
Nails trimmed, dew claws into paw pads so clipped and removed. O will monitor for discharge or signs of infection.
If O sees any signs will book in for a consult + antibiotics.
FAS for nails, wriggly and attempted to bite.
Muzzle and get another nurse to hold for future nail trims.
LB

2024-07-03T00:00:00Z 15:40:51

SE called to follow up on dental rec. also want to query re syringomyelia symptoms ( scratching at neck in clinic during nail trim.

Previous claim history (1)

Date	Claim #	Diagnosis
2024-02-16	C6886816	OVERGROWN NAIL(S)

Line items(lines with upstream diagnosis are skipped by the model)

Line	tstarc	Amount	Date	Upstream diagnosis
10000	tstarc_consultation	124.90	2026-03-11	—
20000	tstarc_antibiotics_-_amoxicillin_and_clavulanic_acid	68.50	2026-03-11	—
30000	tstarc_grooming	34.90	2026-03-11	upstreamDSTP_general_exclusion

UPM+

DG00480CLAW/NAIL DISORDERDSTP_nail_disorder

Variant (sleepy_king)

CLAW/NAIL DISORDER

DSTP_nail_disorder

Conf: 0.770

Threshold: 0.67

Above: ✓

Correct?

Yes No