C09980247 / invoice 10000

Reason: Thoracic Limb LamenessAppointment Notes: Jumped off couch this morning, screamed, limping on front leg. Suspect thoracic IVDD.HISTORY:2 year old female entire boston terrier presenting for acute onset RTL lameness. Ow reports she has jumped off a ledge 1.5m high this morning and yelped in pain. Has been intermittently holding the RPL up since, yelped out a few more times. Has been weight bearing most of the time, seems to be improving.Normal EDUD, no V or D, no PU/PD.UTD with vaccinations and FTW.Relevant history:No history of MSK/neuro issues.Was bitten by an eastern brown snake at 4m of age, received antivenom (no reaction).Not on any medication.PEX:BAR, lovely, very stoicTPR WNLBCS 5/9Clinically euhydratedPerfusion parameters normalPeripheral LN normal shape and sizeCardiovasculatory: no murmur or arrhythmias, pulses SSFRRespiratory: normal respiratory rate and effort, normal bronchovesicular sounds, no crackling or wheezing noted, no tracheal sensitivityAbdominal: comfortable on palpation, no distension or nausea noted, no abnormalitiesIntegument: skin and coat in good condition, no lesions or parasites notedMSK: - G I/IV lameness on RTL, slight stiffness. Mild discomfort on elbow flexion, unable to fully flex. - comfortable on neck and tail manipulation, comfortable on spinal palpation- comfortable on palpation, flexion and extension of the LTL and both PLNeuro: normal mentation, no ataxia, no abnormalities notedUrogenital: no abnormalities notedRectal: perianal area clear, rectal exam not performedDIAGNOSTICS:None performed ASSESSMENT:Problems:- G I/IV lameness on the RTL- slightly reduced ROM in the R elbow, mild discomfort on flexionDDX: soft tissue injury vs elbow subluxation vs microfracture vs otherPLAN/ DISCUSSION:- discussed the ddx- given the mild presentation and improvement within the last few hours, most likely just soft tissue injury- started on a short course of meloxicam- if the lameness persisting/ getting worse, to bring back for radiographs- as brachycephalic, more likely to develop GI issues on meloxicam - any V, D or inappetence -> stop giving, ring us and can swap over to paracetamolTREATMENT:Meloxicam 0.1 mg/kg PO SID for 5 days    Vital Signs    Weight: 7.3;       MMColour: pink;       Temperature: 38.7;       HeartRate: 100;       BodyScore: 5/9;       RespirationRate: 28;       CRT: 1s;