C10029722 / invoice 10000

13/03/2026 History: 
O's glass door shattered approx. 1hour ago and dog walked through glass cutting front and back paws - have come straight down.
Otherwise Woody has been healthy 
ate approx 10am, the

Medications: nil

Examination :  
Demeanour: BAR/anxious - mouthing to try to examine sore paws. Muzzled for limited exam
BS=  4.5/ 9    
DS=   0/ 4          
HR= 120, n   
RR= pant, n    
MM=  pink, moist, <2  
Temp= not taken
abdo, eyes, ears, msk nad
skin: back L paw deep, irregular laceration to digit 2 pad. FRL appears to have laceration to palmar aspect of medial metatarsal - unable to examine well.
Both wounds still minimally bleeding and fresh

Lab: O declined bloods

Assessment: 
deep lacerations to paws - requires suturing

Plan: 
admit for suturing - O consents. 

pre-med:
-0.5mg/kg metoclopramide SC (ate a few treats before cons)
-0.3ml medetomidine + 0.8ml butorphanol IM

IV catheter placed, topped up with 4.5ml alfaxan IV throughout procedure to keep sedated
-flow by mask O2 throughout
-lignocaine 0.5ml ring block around both lacerations. 

Procedure:
-aseptic clip and clean with dilute chlorhex and saline flush of wounds (2 separate full thickness wounds to palmar aspect of RFL metatarsal region just caudal to digit 1 + digit 2 pad surface of LHL). 
-RFL wounds - placed 2.0absorbable monofilament suture simple continuous SC pattern. Closed skin with combination of cruciate and simple interrupted sutures (3.0 and 2.0 absorbable monofilament)
-LHL digit 2 wound - narrow base of flap of pad tissue present - some concern re vitilisation of this tissue but attempted to salvage/close. Placed single simple interrupted SC suture using 2.0monofilament absorbable. Closed pad with multiple cimple interrupted skin stutrures (2.0 mononfilament absorbable)

-dressed both paws with melonin,(cotton wool interdigitally) softban, gauze, vetwrap and elastoplast cuffs)

-gave 0.2ml meloxicam SC post op

Plan:
-home with dressings to be changed monday at recheck apt (gaba + trazodone to be given 2-3hours before apt to enable this)
-start PO amoxiclav tonight 
-start PO meloxicam tomorrow PM
-keep very quiet at home (O declined more gaba and traz for this)
-O has e collar at home if needed to stop bandage damage
-old drip covers to protect bandages when toileting
-warned O risks of infection and devitilisation of tissue following these wounds
-warned O likely to need multiple bandage changes over couple of weeks
-sutures out in 2 weeks

13/03/2026 Owner is a human nurse. He was wondering if all looks well on Monday, could he do the redresses at home himself? He is happy to buy the materials elsewhere.