C09971959 / invoice 10000

Reason: Recheck LegAppointment Notes: Overdue remindersECplease leave at 30mins  ------- Sms reply: YHistory-Update:Consent has been given by the client to proceed with this treatment  -  YesHISTORY:- Recheck for intermittent left forelimb lameness. Chronic issue, previously investigated with two rounds of X-rays- Lameness is exacerbated by chasing a ball and change of direction movements.- Owner has implemented strict rest for the past month (minimised walks, no ball throwing) as per previous veterinary advice, with resolution of clinical signs during this period.- Owner reports historical immobility in the left forelimb and, by extension, the left hindlimb.- History of intermittent episodes of loose stools, approximately once a month, lasting 2-5 days. Occasionally progresses to diarrhoea.- GI signs may be associated with dietary changes (e.g., addition of meat) or eating grass.- No episodes of loose stools in the past two weeks.- Past faecal testing for parasites was performed approximately three years ago.EXAMINATION:MSK: Ambulating normally in consult. Good passive ROM of joints. Some discomfort with palpation of quadriceps LH. Small amount of resistance/discomfort with extension of LF shoulder.LABORATORY:None todayASSESSMENT:1. Intermittent left forelimb lameness, suspect elbow dysplasia or shoulder joint pathology based on history.2. Intermittent gastrointestinal upset (loose stools).- DDx dietary indscretion vs infection vs other PLAN:- Start gradual increase in exercise for the next 2 weeks, on leash walking only. Can move on to playing w/ ball if no limping after 2 weeks.- Continue to monitor the limb. A CT scan remains a possibility if signs recur or worsen.- Discussed that high-impact activities (ball chasing) involving rapid changes in direction and hyper-extension of the shoulder and elbow are likely triggers.- Dispensed a faecal sample container for the owner to collect a sample if GI signs recur. Can perform inhouse FF as first step. A faecal PCR test was discussed as a further diagnostic option.    Vital Signs    Weight: 26.5;