C09971256 / invoice 10000

Triage Nurse:Triage Nurse notes:----------------------------------------------------------------------------------------------------Usual General Practice: AEHL Veterinarian: JackieDay & Time:HX4-5 days R foreleg lameness after visit to dog park. Was running around a lot.Couldn't get into reg vet this week but today was very concerned - seems to be getting worse. Has been struggling to go outside to the toilet bc sore up and down stairs. Has another 1 yr old dog at home. Play and run around togetherSometimes gets lameness - intermittent. HAs been previously dx w OA.Has had some panadol over last last 5 d, as per advice from reg vet. Not on any other meds. Was on Beransa for a while but has stopped thisStruggling to go outside, struggling to move around easily1 yr old dog at homeAlso lame in R hindleg - O had not noted this one bc foreleg is worseEDDU WNLHad 6mthly bloods while on Beransa but has not had one for a while. Medical notes/Known chronic health concerns: OAExamination:BARMM p/mLN NADAbdo palp NAD Weight bearing lame, L foreleg and L hindleg - short stepping on hindleg. Hard bony swellings around bilateral  medial carpi and tarsi, worse on L side. Painful on palpation  and flexion of L carpus - repeatable reaction. Adequate ROM in other joints. No pain palpable in long bones. Spinal palp NADProblem List:Lame - carpi and tarsi - worse on L side. Differential Diagnoses (in order of most likely):OA, soft tissue injury, osteosarcomaClient Communication: Discussed work up - rads and bloods. Preferable to do rads under GA at reg vet but can do bloods today - O happy w this. Unable to do bloods as dog reactive and became very stressed. Given unable to do bloods, discussed pros and cons/risks of NSAIDs. O keen to go ahead w NSAID trial w understanding of risksDiagnostic Plan:Bloods - unable to draw blood today - dog very strong and reactive. Will do better w sedation/Trazodone on boardTreatment: NILOngoing Assessment & Plan:Meloxicam tgh 1.4ml SID PO x 30mlRevisit w reg vet asap for bloods and rads under sedation/GA    Vital Signs    

Lame for the last 4-5 days front right.Triage Nurse:Triage Nurse notes:----------------------------------------------------------------------------------------------------Usual General Practice: AEHL Veterinarian:Day & Time:History:Medical notes/Known chronic health concerns:Examination:All vital signs and clinical exam findings as recorded.Additional clinical exam findings as follows:•	…….Problem List:Differential Diagnoses (in order of most likely):Client Communication:Diagnostic Plan:Treatment:Ongoing Assessment & Plan:    Vital Signs    Weight: 22;       MMColour: Pink;       CRT: 1-2;