C10018199 / invoice 10000

Presented for -  recheck paw. 

Removed bandage. Quick exposed, but healing well. Otherwise Rufus is fine 
Temp 38.7 
Owner wants to try without bandage, Rufus doesn't like it. With cone on. 
Happy to try this, if any concerns can come back to get it rebandaged. 

Plan: 
Walk out with sock on only and soak in iodine when returning. 
Keep cone on 24/7 
Continue meloxicam until monday 
REvisit monday If no concerns. 

Post op call 8:37am -spoke to Brittany. Rufus doing well today, a bit quieter as doesn't really like the bandage but eating and drinking normally. Bandage check booked for thursday. O will let us know if any concerns before this.

Reason: Sedate + torn nail
History:
See prev hx - torn nail RF digit 3

BAR
MM p/m
CRT <2s
HR wnl, no murmur or arrhythmia
RR wnl, clear lung sounds

Sedation: Butorphanol 0.4ml / Medetomidine 0.4ml IV - good level sedation
Reversal: Atipamezole 0.4ml IM

Hair lightly clipped around RF digit 3. 
Ring block around distal toe with lignocaine ~0.5ml total
Nail broken longitudinally all the way to base. Able to remove entire nail in 2 parts. Quick remaining appears quite healthy with bed of granulation tissue forming. 
Nail trimmed back as short as possible. 
Entire toe/quick cleaned thoroughly with dilute betadine. 
Once paw dried, bandage placed - melolin, soffban, conforming bandage, vetwrap, elastoplast
All other nails clipped. 

Treatment:
Continue melox and amoxyclav
E collar if required
Bandage care notes printed

Plan:
Recheck in 2-3 days to remove bandage. May require a second bandage or if looking good can leave open with E collar instead.