C09977021 / invoice 10000

Reason: Limping, Yelping In Pain Appointment Notes: O said she is acting very strange, yelping in pain when O is gently touching stomach, said dog's where unsettled last night as the storm came through and could've possibly hurt herselfHistory: Is terrified of storms and O didnt realise so she was outside. Looked like a big scene outside - bed is upside down etcThis morning - she looked like she was limping, yelped when O patted her. Yelped again when O touched her stomach RF lameness. Did see this a few days ago even before the stormLethargic, didnt want to go for her walk Ate breakfast happily Eddu normally the last few days No vomiting or diarrhoea Utd flea tick worming No currnet medications No ocughingPossible wheezy breathing sometimes?Examine: Bar Hr 112 gr III-IV/VI heart murmur Clear lungsMm pink and moist crt <2sAmbulating well in consult except intermittent toe touching lameness RF Jumping onto couch during consult Slightly tense thoracolumbar spinal palpation Good ROM cervical spine Good ROM hips Patella luxation grade 2-3 bilaterally No wounds found on RF -- no swellings, good ROM carpus, elbow, and shoulder LF elbow deformity, crepitus Ln not palpably enlarged Assessment: Acute onset lameness RF + yelping DDx MSK trauma, acute on chronic suspected New heart murmur Plan:1. Gabapentin 50mg - 75mg po bid x 5 days 2. Strict rest 1 week 3. INI then consider sedate and rads --> RF and spinal If deteriorating ie paresis/paralysis may need advanced imaging - spinal MRI 4. O to monitor resting RR, if consistently >30 bpm then needs chest rads ; or if coughing, wheezy etc. 5. Recheck in 2-4 weeks to discuss long term management - joint health, recheck heart    Vital Signs    

Reason: BDR 11/12 -15/12    Vital Signs    

Reason: 2nd LeptoAppointment Notes: CW OK'DNo issues after first set. Doing well 2nd lepto adm sc scruff - due 12/26    Vital Signs