C09977804 / invoice 10000

Reason: Limping, Front LeftAppointment Notes: zzSubjective: O thinks jumped off the bed a few days agoHas had a limp in one of her front legs for the last 3-5 daysWas bad Sunday, improved a bit since then but still thereEating and drinking seem OK. On renal diet with a bit of fancy feast to encourage her to eat.No obvious bleeding or swelling. Indoors only.Examine:BAREyes NADEars NADOral: MMs pinkCardiac NEAbdomen NEMSK: Mild lameness on L fore walking in consult roomThickened elbows and restricted shoulders bilat. No obvious crepitus or swelling.Hips and stifles similarly thickened.BCS 3.5/9 has lost 500g since last seenAssessment: Suspect DJD with flareup/acute on chronic injuryRenal disease - suspect progressionPlan: Focus on lameness to start - place on gabapentin BID for next 3-5 days, and start on solensia trialINI on this might need to consider CBD oil, buprenorphine, long term gabapentin at low dose depending on side effectsRecc we follow up with kidneys - ideally bloods as has been about 8m since last seen, and we never did do BP testing so recc this; can manage at recheck next week if lameness betterAdvise that as we are giving normal food in addition to renal diet this may make renal diet less effective.Treatment: Gabapentin 20mg BID POSolensia SQ    Vital Signs    Weight: 3.7;       

    Vital Signs    

    Vital Signs