C09977220 / invoice 10000

Reason: Injured LegAppointment Notes: Overdue remindersHistory:Presenting for: Louie, a nearly 3 year old male desexed Pomeranian (7kg), presented for lameness affecting the right hind leg. Owner reports the dog was sitting on the sofa when he yelped and subsequently developed lameness.Historical Conditions:- Predominantly seen for skin problems and hot spots with suspected allergic component- Known patella luxation identified at 4 months of age by previous vet who advised monitoring as it may improve with maturity- Described as a bit of a biterCurrent Meds:- Occasionally antibiotics for skin conditions- Very short courses of prednisolone and neotopic as needed- No ongoing medicationsOther:- Pants frequently, described as soft panting with snoring due to soft palate- Generally good behaviour in car and with groomer Brandon- Doesn't eat large amounts, owner attempts to give vegetablesExamination:Wt: 7kgBCS: Overweight - should be approximately 5.5kgBehavioural: Anxious and protective during examination, reluctant to allow handling, exhibits biting behaviourCardiovascular: Healthy heartbeat notedMusculoskeletal: Right hind limb lameness present, still weight bearing. Patella luxation palpated - felt patella dislocate and relocate during examination. Joint feels stable on cruciate assessment. No significant swelling noted on medial aspect of stifle. No digital pain in either hind foot, nails intact, no saliva staining from excessive lickingAssessment:Patella luxation - acute exacerbation likely triggered by twisting motion while on sofa, causing temporary dislocation and painPlan:New Meds/Tx:- Previcox 57mg tablets, one daily for 10 days for anti-inflammatory effect. Discussed potential GI upset (vomiting/diarrhoea) as possible side effect. Paper script provided for ongoing supply if needed long-term ($55 script fee, significant cost savings compared to clinic dispensing)Additional Discussion:- Explained that if patella-related, anti-inflammatories will help with pain/inflammation but won't fix underlying mechanical problem- Discussed provisional booking for radiographs under anaesthesia in approximately one week to assess severity and surgical candidacy if condition doesn't resolve- Surgery generally has very good success rate for patella luxation in dogs- Weight reduction strongly recommended to reduce joint stress- Discussed option of veterinary chiropractor as alternative approach- Client will monitor response to anti-inflammatories over next weekClient Comms:- Advised to continue anti-inflammatories and assess improvement- Provisional X-ray booking arranged for next Thursday (can be cancelled if condition resolves)- Contact clinic if condition worsens or doesn't improve- Discussed cost savings of prescription medications vs clinic dispensing    Vital Signs    Weight: 7;