C10018832 / invoice 10000

WEIGHT: 28.9
HISTORY: 02 Mar 2026 08:56:42 pm EXF

Client consented to use of dictation software
Reason for presentation: Avulsed right forelimb dewclaw nail.

History: Patient is a German Shepherd cross Staffordshire Bull Terrier, desexed female, date of birth 11/03/2023. Adopted one month ago as a rescue. This is the first veterinary visit with the current owner. Diet consists of kibble with occasional tuna and sardines. No known history of explosive diarrhoea with sardines. The patient has a history of nipping behaviour. The injury occurred approximately five days ago when the patient caught the nail while jumping into a car. Patient has been licking the affected area.

Medications: simp trio

Clinical examination:
Mentation: Bright, alert, and responsive. Confident and well-balanced for a rescue animal.
MM/CRT: pink moist 1-2
CV: 100 NM NA FSS
R: pant clear bronchovesicular sounds 4/4 fields.
Dental: 1/4
PLNs (submandibular, pre-scapular and popliteal): soft, small, symmetrical
Eyes: Clear OU, pupils symmetrical and tracking - no swelling, discharge, erythema, hyperaemia or blepharospasm
Ears: no erythema malodor or discharge 
Abdomen: soft and comfortable with no palpable organomegaly
Skin: short clena coatf rree of visible ectoparasites
Temperature: n/p
Rectal examination: n/p
MSK: Avulsed nail on the right forelimb dewclaw. The quick is exposed and the nail is minimally attached.
Neuro: appropriate
Urogenital: Desexed.
BCS: Weight 29.9kg.

Problem list:
Avulsed right forelimb dewclaw nail.

Differentials:


Client communications:
Discussed the patient's background as a rescue that has been rehomed multiple times. Noted the patient's good confidence and behaviour, with no signs of aggression despite being a German Shepherd cross. The patient exhibited a fawning response rather than aggression when stressed. An initial attempt to remove the nail in the consult room was unsuccessful due to the patient's strength and excitement. Discussed the plan for sedation to remove the nail. Advised that a cone collar will be required for three to four days to prevent licking, which could lead to infection. The possibility of the wound bleeding was also mentioned. Provided an estimate for the procedure.

Treatment/plan:
Admitted for sedation for nail removal.
The procedure will be performed today. The patient can be collected around 9:00 PM.
The plan is to remove the nail to prevent further pain and infection, allowing the patient to be more comfortable. This approach avoids continued attempts at removal while conscious, which could be traumatic.



IM sedation 15ug/kg medetomidine + 0.2mg/kg methone
smooth sedation and recovery. 
reveresed with 0.4mls antipam IM

Bandage applied to RF + elizabethen collar
Bandage can be removed in 3 days
0.2mg/kg metacam sc on recovery r/c 1 week