C09970924 / invoice 10000

Reason: Hip Issues.History: Has had discomfort in both hips for a while now but became much worse when girls were in season recently and he constantly tried to serve them (despite being desexed and unsuccesful!). Is on supplements for arthritis but no medications due to his kidney compromise.Examine: Stiff gait, shift weight to right pelvic limb when standing. Bilateral muscle wastage in hindlimbs. No pain/ crepitis nor abnormailities detected in feet, hocks nor stifles. Extreme pain reaction on attempted extension of hips bilaterally and crepitis palpable. Plan: Radiographs if not improving to ensure no more sinister cause Discussed referral for total hip replacements are only way of really reliving pain from hip OA if very bad- o not keen given ageDiscussed managing OA- weight management (already a good BCS), pain relief (nsaids not an option for him but paracetamol 20mg/kg po bid, gabapentin are a good place to start), discussed supplements, recommended physio.    Vital Signs    Weight: 25.7;