C09970785 / invoice 10000

Reason: Shaking, QuietAppointment Notes: Overdue remindersHistory: Since getting home today was more quiet, standing under the chair shaking profusely and wouldn't come out. Calmed down after 5 mins, then was quiet/slept for half an hour before shaking again.Front legs would slowly give out and slide forward. A couple of weeks ago, was doing zoomies around the house, then back legs gave out, and head flopped upwards. Passed out for a few seconds and then came to.Prior to this event today was normal, EDDU. Has been a bit off since Jasper (other dog died). No access to toxins. Examine:QAR. Tremouring. CV: normal rhythm, rate & regularity.RESP: panting heavily but normal lung sounds all fieldsEYES/EARS/INTEGUMENT: NAD.ABDO: soft and comfortable.NEURO: normal CNs. No neck pain on manipulation but mild repeatable cervical spinal pain. Mild repeatable TL pain. CPs in all limbs normal. Normal gait. No ataxia. TEMP 40**Assessment: PUOBroad PUO ddx: infectious/inflammatory (spinal/MSK/neuro), immune mediated, neoplasia. Advised to start with bloods.Also collapse episode that happened a few weeks ago sounds like cardiac disease?? (syncope?? - over exertion from excitement lead to collapse/orthopnoeic stance and then suddenly came to, and back to normal). May want to do echo to work this up, esp if happens again.Laboratory: Mild non/pre regenerative anaemia. Mild stress leukogram.Marked CRP elevation.Assessment: bloods revealed marked inflammation somewhere but non-specific.Rec doing imaging workup tomorrow or at least coming for a temp check tomorrow. May need whole body CT (preferred option) or at least xrays/abdo ultrasound. Treatment:Meloxicam 0.2mg/kg (0.34ml) SC.Plan:RV tomorrow for temp check +/- further imaging.Check to see if neck/spinal pain still present or any other signs present that may give clue to underlying cause.    Vital Signs    Temperature: 40;