C09974422 / invoice 10000

Indicates bilateral moderate elbow dysplasia.STO. Plan is as follows1) recheck one week to commence synovan (O will give 2/3/4th at home).2) weight loss - aim for BCS 4/9.3) Rec osteoadvanced sup.4) Melox when neededConsider surgical referral if lameness progressing.

HX:Last few days since big walk has been lame RFL.Acquired as older pup, has had intermittent mild lameness RFL. Always improves quickly but this time seems worse.Otherwise well dog.Lives with two other dogs.Vax/Prev UTDPrev vet Normo.EDUF normal.EXAM:BAR. Happy boy.BCS 6/9. O said has gained few kg.MM pink. CRT<2secs.Hs/LS clearEyes/ear nad.LN nad.Teeth excellent.Abdo nad.Good coat.I/IV lame RFL. Resents elbow flex and extension but very wriggly to localise compared to shoulder?No neck pain on palpation or flex.Other legs nad.Advised based on breed and hx suspicious of elbow dysplasia. Rec rads. Consent given. Risks discussed. Is insured.Admitted for sedate, rads and radiologist report. Briefly mentioned surgery.Given trazodone 300mg PO 9:45amZHExam as above, grade 1 lame RF, stiff and resists elbow flexionSedated 0.4mL butorphanol (0.1mg/kg) and 0.8mL (0.02mg/kg) medetomidine i/v, sedation not quite deep enough so given additional 0.3mL medetomidine i/vR&L lateral views of elbows (including flexed), shoulders, carpuses and Cr-Ca views of elbows, shoulders and carpuses taken. To send to imaging vets for specialist report.No significant crepitus evident on palpation of joints under sedation.Nails trimmed.Reversed 1.1mL antisedan i/m, woke up well.TGH with meloxicam 30mL - 2.4mL once a day with food as necessary (dosed for 36kg dog), start tonight.Images sent and case submitted for reporting with Imaging Vets.Await specialist report, continue restricted activity in meantime, NSAIDs as necessary if lame.