C09972657 / invoice 10000

Reason: Breach Birth & Now Sits WrongAppointment Notes: Special payment terms existStudent: Gina Costello Reviewed by: History::Maia is a 9-month-old entire female long-haired miniature dachshund presenting today as her owners are concerned she “sits weirdly,” with her hindlimbs positioned out to the side. The owners report that she has sat this way since she was young and had hoped she would grow out of it; however, this has not changed.Maia does not show any overt signs of pain or discomfort at home. She runs, jumps, and plays normally. The owners report that when they pick Maia up onto the bed and pull her toward them, they sometimes notice a “click” from her hips.Maia was reportedly in breech position at birth. The owners are dachshund breeders; Maia is from their most recent litter. They own the dam but not the sire. Both parents have undergone genetic testing with no reported abnormalities.The owners note that Maia has a 90-degree kink at the distal aspect of her tail. Manipulation of the tail appears painful; otherwise, it does not affect her.Today, the owners would like to investigate whether there is any underlying abnormality contributing to her sitting posture.Regarding desexing, the owners have researched potential associations between desexing and IVDD risk and are currently reluctant to proceed. They do not intend to breed from Maia; however, there is an entire male dog in the household.Current Medications: NilDiet: Royal Canin Dachshund adult pouches (x2 daily) + ½ cup Royal Canin dry kibbleAppetite: GoodUrination/Defecation: Normal as per ownerVomiting/Diarrhoea: None reportedVaccination: UTDParasite Prophylaxis: Bravecto chewable + routine dewormingExamination::Demeanour: BAR, very friendly, loves treats Weight: 4.9 kgBCS: 4/9HR: 128 bpmRR: sniffingTemp: 38.4°CCRT: <2 secondsMM: Pink, moistHydration: Adequate (normal skin tent)Systems ReviewEyes: Clear, symmetrical; no hyperaemia, discharge, or blepharospasmEars: External canals clean; no erythema, discharge, or malodourOral cavity: No masses or lesions observed; no obvious deformities. C0G0Thoracic auscultation: Normal inspiratory and expiratory effort; clear bronchovesicular sounds bilaterally; no murmurs auscultatedPeripheral lymph nodes: Submandibular, prescapular, and popliteal LNs normal size and symmetricalAbdomen: Soft and non-painful on palpationUrogenital: Normal conformation; no dischargeIntegument: Coat clean; no ectoparasites, wounds, or masses notedMusculoskeletal:- Ambulating normally and weight-bearing on all four limbs- No spinal pain elicited on palpation- Good cervical range of motion- Left hip: palpable clicking on flexion/extension- Right hip: mild reluctance to full flexion/extension (exam discontinued to avoid discomfort) Left patella: mildly mobile (consistent with possible Grade I luxation)Neurologic: Full neurologic exam not performed; no obvious deficits observed on gait or general assessment.Rectal: Not assessedPain Score: 0/24 (MGS)Problem List:1. Abnormal sitting posture 2. Palpable clicking left hip3. Reduced ROM right hip4. Mildly mobile left patella5. Kinked distal tail (painful on manipulation)Assessment: Maia is a 9-month-old miniature dachshund with a chronic abnormal sitting posture and mild orthopaedic findings on examination.Differentials for her presentation include:- Conformational/behavioural “puppy sit”- Mild hip laxity or early hip dysplasia- Grade I patellar luxation (left)Less likely: neurologic cause (no deficits identified on examination)Although she is not currently demonstrating clinical lameness, the presence of hip clicking and reduced ROM warrants further investigation to assess for underlying hip laxity or developmental hip dysplasia.The breech birth is unlikely to be contributing to her current presentation, given the absence of neurologic deficits or historical developmental abnormalities.At this stage, findings are mild and not associated with overt pain or dysfunction.Plan: Diagnostic Imaging- Sedated hip and stifle radiographs recommended for definitive assessment of hip conformation and patellar positioning.- Estimate provided: $1000–1200.- Owners elected to proceed with imaging.Joint Support- Commence 4Cyte supplement for joint health support.Weight & Exercise Management- Emphasised importance of maintaining lean body condition (BCS 4–5/9).- Encourage regular, controlled exercise to support joint stability.Desexing Discussion- Discussed current literature regarding IVDD and desexing timing.- Explained that evidence is mixed, with some studies suggesting no increased risk and others recommending delayed desexing until skeletal maturity (~12 months).- Owners will consider desexing at 12 months versus managing entire status (e.g., supervision or use of protective garments during oestrus).Monitoring- Monitor for development of lameness, reluctance to jump, skipping gait, or spinal pain.- Recheck following imaging results.    Vital Signs    Weight: 4.9;