C09976658 / invoice 10000

Reason: Sore legAppointment Notes: Booked Online: 02/03/2026 16:22:04 PMBooking Type: Health CheckBooking Notes: Sore leg Owner Name: Tiffany  LubkeOwner Email: t.stevens.04@hotmail.comOwner Mobile Number: 0421832526Pet Name: HarleyPet Species: DogWeb BookingClient name: LubkeContact number: 0421832526Email address: t.stevens.04@hotmail.comPatient name: HarleyReason: Client Present:Nurse: AT EDDU normal Healthy Pets Wellness Testing: Done Yes / NoVaccination Type: UTD C5Intestinal worming: NGS @home Heartworm Prevention: NGS @home Flea Prevention: NGS @home Tick control: NGS @home Microchip: yes Insurance and Healthy Pets Plus:Behaviour concerns:Current medications: 1/2 25mg tablet prednisolone Current Diet: Type of Shampoo/Frequency:Toileting: normal Current medications: Prednisolone 12.5mg for 3 days last week.Current Diet: Supermarket dog roll. Has a history of diarrhoea with some dry foods (puppy diet, senior golden retriever kibble). Tolerates wet food better. Inappetence for breakfast.Type of Shampoo/Frequency:Toileting: Intermittent diarrhoea with some mucus reported.History: 12-year-old male neutered Golden Retriever presenting for assessment of right forelimb lameness. Has a history of left forelimb lameness with radiographic evidence of arthritis (x-rays performed last year). The owner now reports the right forelimb is also painful. Concerns also raised regarding weight loss (0.5kg since December 2025) despite attempts to increase caloric intake. He has a history of two bowel surgeries and subsequent poor weight gain.Examination:Demeanour: Bright, alert, responsive.Temperature:Hydration Level: Adequately hydrated, pink mucous membranes, good skin tent.Eyes, Ears, Nose, Throat: Mild cerumen in both ears, cleaned. Eyes, nose and oral mucosa unremarkable.Capillary Refill Time/Mucous Membranes: Pink, CRT <2 seconds.Oral exam/Calculus level (0-4): Mild to moderate calculus and gingivitis.Cardiovascular/Heartrate: HR: normal rate and rhythm. No murmur auscultated. Pulses are strong and synchronous.Pulmonary/Respiratory: Lungs clear on auscultation. Increased panting reported by owner, especially at night. Suspect age-related laryngeal changes (laryngeal paresis/paralysis) as the cause for increased stertor.Peripheral Lymph nodes: Normal size and texture.Abdominal Palpation: Soft, non-painful. No organomegaly or masses palpated.Urogenital: Male, neutered. No abnormalities noted.Rectal: Not performed.Skin/Integument and Nails: Coat in good condition. Nails appropriate length.Musculoskeletal/Neurologic function: Lameness evident on both forelimbs, left worse than right. Palpable thickening of the medial aspect of the left elbow joint, consistent with osteoarthritis. Tightness noted in iliopsoas muscles. Mild proprioceptive deficits noted in hindlimbs (toe scuffing).Muscle Condition: Mild to moderate generalised muscle atrophy, most significant over hindlimbs.Pain Score (0-5): 2/5Laboratory: Bloodwork from 19/12/2025 was normal. Recommended recheck in mid-June 2026.Assessment:1. Osteoarthritis: Affecting both elbows (left worse than right) and likely other joints (hips) contributing to lameness, stiffness, and pain.2. Weight loss/Poor body condition: Likely multifactorial, secondary to chronic gastrointestinal issues (history of bowel surgery, possible short bowel syndrome) and potential malabsorption, exacerbated by reduced caloric intake.3. Chronic enteropathy: Intermittent diarrhoea with mucus, poor tolerance of some diets.4. Suspected laryngeal paresis: Contributing to increased respiratory noise/panting.Treatment:Discussed multimodal pain management for osteoarthritis.Discussed dietary management for weight gain and gastrointestinal signs.Consent has been given by the client to proceed with this treatment - yes.Plan:1.  Pain Management:    -   Provided a prescription for Meloxicam (Mobic) 7.5mg tablets. Dose: quarter of a tablet once daily with food as needed for pain. Advised owner on potential side effects and the need for a washout period if switching from/to other anti-inflammatory drugs.    -   Discussed long-term pain management options including:        -   Pentosan polysulfate injections (course of 4 weekly injections).        -   Antinol (joint supplement). Will notify owner when samples are available in April.        -   Librela (Beransa) monthly injections.        -   Gabapentin as a potential future adjunct for neuropathic pain.    -   Emailed owner detailed information on all discussed medications, including costs, for their review.2.  Dietary Management:    -   Recommended changing diet to a prescription gastrointestinal formula (e.g., Royal Canin or Hill's Gastrointestinal) for both Harley and his housemate.    -   Advised offering the kibble version to increase caloric density and aid weight gain.3.  Recheck: Recommended repeat wellness blood panel in mid-June 2026. Advised to re-present sooner if lameness worsens or other concerns arise.    Vital Signs    Weight: 21;