C09975758 / invoice 10000

02/03/2026 

Presenting Complaint: Acute onset hindlimb lameness and lump noted behind right knee.

Hx: BIB Craig
11 year old dog.
Lameness started 3 days ago (Friday).
Initially lame on left hind leg.
Yesterday, lameness appeared worse in right hind leg.
Also noted a lump behind the right knee yesterday.
History of arthritis in hips. Possibly in FLs as well
Owner reports he was a little bit slower with his food last night, which is unusual.
Walks morning and afternoon, usually swims more than runs.
Recently, has been collapsing in the back legs on walks.
Has gained weight recently after staying with parents who walked less and fed more

Diet: not discussed
Medication:
Panadol 500mg 1 tablet given this morning at 10am.
Meloxicam given this morning with breakfast. Sourced from home, likely expired from 2023.
Parasite and Vaccination Preventive: not discussed

PEx:
Temperament: BAR, nervous and dislikes HLs being palpated historically
BCS: 5/9
MM: pink and moist, CRT: 1-2 sec
Mouth: not examined due to growling
eyes: NAD
ears: NAD
nose: NAD
Cardiovascular: HR: 130 = PR Murmur: No
Respiratory: RR = 50, lung sounds are normal
Lymph nodes: Right popliteal lymph node markedly enlarged, approx 3-4cm. Other peripheral lymph nodes palpate as normal (inguinal, prescapular).
Abdominal Palpation: NAD
Skin/Coat: NAD
Musculoskeletal:
Generalised hindlimb weakness/lameness, appears sore on both hindlimbs. Slight limp observed LHL
Vocalised and tensed on palpation of the distal right femur/stifle region.
reduced hip extension bilat.
No obvious abnormalities palpated on bones or joints of distal hindlimbs.
resents LFL flexion/extension - unsure if elbow or shoulder
RFL nsf
Genitalia: NAD
Rectal temperature: unable to take

Assessment:
Right popliteal lymphadenopathy (3-4cm).
Acute onset, shifting hindlimb lameness. 
History of coxofemoral arthritis.
Pain on palpation of right stifle/distal femur region.
Differential diagnoses for lymphadenopathy and lameness include neoplasia (e.g. osteosarcoma with regional metastasis), infection, or severe inflammatory response due to DJD

Tx: 1.5ml meloxicam sid 10d

Plan:
Discussed two options with owner:
1. Conservative management: Trial of appropriate pain relief and monitor response. This does not investigate the enlarged lymph node.
2. Further investigation (recommended): General anaesthetic for full clinical workup.
Workup would include:
- Pre-anaesthetic comprehensive blood tests and urinalysis.
- Full body radiographs including chest, spine, hips and both hindlimbs and forelimbs to assess for bony lesions (especially distal femur RHL) and screen for metastasis w/ thoracic rads.
- Fine needle aspirate (FNA) of the right popliteal lymph node for cytology at vetnostics.
Discussed prognosis of bone cancer if diagnosed is generally poor.
Owner is considering the investigation option and will discuss with partner.
Provided an estimate for investigations: approx $2200-$2300.
If booking for procedure, owner to call reception to schedule.
Pre-anaesthetic medication (Trazodone) to be collected prior to admission.
Dispensed Meloxicam 15ml bottle. Dose: 1.5ml PO SID with food for 10 days. Advised to cease if any vomiting, diarrhoea or inappetence.
Advised owner to adjust 500mg Panadol dose to 3/4 of a tablet for his body weight.
Owner to call to book in for procedure.

Consult Summary:
Acute hindlimb lameness and a large (3-4cm) right popliteal lymph node in an 11yo dog.
Concern for underlying neoplasia such as osteosarcoma.
Recommended investigation via GA, bloods, imaging (full body x-rays) and FNA of the lymph node.
Owner to discuss with partner and call to book.
Dispensed meloxicam for pain relief in the interim.