C09979404 / invoice 10000

Reason: Limping On Front Foot ASVerified: yesSubjective:Diet: Recent changes to diet: nilPreventative healthcare:Vacc: due Friday for vaccinationsHWP: IW: Flea/tick: HISTORY:O's presenting complaint/s:  has been off all week, refusing walks, normally takes daily walks due to arthritis- Monday refused to go for walk- Tuesday got partway down road then wanted to come home- Wednesday refused walk again- Doing a lot of sleeping- Has lump on top of paw that has been more pronounced last few days- Hind leg patella collapses when excited, sits down- Had episode of diarrhoea which settled with Pro-KolinAppetite: Normal - still eatingThirst: NormalVomiting: NilDiarrhoea: Recent episode settled with Pro-Kolin treatmentAccess to chemicals or toxins: Nil knownAccess to rodenticides: Nil knownCurrent medications: - Beransa (ongoing)- Synovan (every 3 months for joint cushioning)- Pro-Kolin (given for recent diarrhoea episode)Previous medical history: - Arthritis with previous x-rays showing arthritis over pelvis- Liver condition- History of gastrointestinal sensitivity- Previous patella issues with hind leg collapseExamine:PHYSICAL EXAMINATION:Mentation: alert and responsiveEYES: NAD - clear, no noted dischargeEARS: NAD - clear, no discharge, odour, erythemaNOSE: NAD - clear, no discharge, symmetrical, no lesionsORAL: NAD - normal pink and moist mm, normal CRT, healthy teeth & gumsCARDIOVASCULAR - NAD - no murmur or arrhythmia auscultated, pulse pressures normal and synchronousRESPIRATORY: NAD - thoracic auscultation clear sounds bilaterally, respiratory effort normalABDOMINAL: NAD - soft pliable, no detectable pain or palpable abnormalitiesNEURO: NAD - neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMUSCULOSKELETAL: tenderness in elbow, pronounced swelling and inflammation in digits ##RECTAL: not performedREPRODUCTIVE: externally normalINTEGUMENT: lump on top of paw, always present but more pronounced recently #LYMPH NODES: NAD - peripheral nodes palpate normalAssessment:Problem List:- Acute flare up of joints- Chronic arthritis with liver disease considerations- Elbow tenderness- Swelling and inflammation in footTreatment:- Beransa- Synovan injection- Previcox 1/2 tablet once daily with food for anti-inflammatory effectPlan:- Previcox dispensed for acute anti-inflammatory treatment- Vaccinations scheduled for Friday- Consider Pregabalin for long-term pain management if needed- Monitor response to current treatment- Recheck next month    Vital Signs    Weight: 24;