C09980999 / invoice 10000

03/03/2026 CM: mobile visit- 
History:  she cannot walk around or get up for 2 days. Hx of back/lumbar pain in 2024. Cath thinks one brief episode of back pain at home since then, which responded to meloxicam.
Mello was walking slowly and seemed uncomfortable when she came in from the yard on Sat 28/2 pm. Was reluctant to get up out of bed on Sun 1/3 and O noted she was weak and wobbly in the HLs. O gave her oral meloxicam 0.8ml at home on Sun am and 1/2 dose Mon am, then another 0.8ml po this am.
Mello has remained reluct to move- got up when the postman came this am but was quite ataxic esp in the HLs..
Is eating when hand fed, but less than usual,  is drinking, no vomiting or diarrh. O not sure when she last passed poo, urinated last pm.
Is on BravectoQ for tick prevn, no coughing/retching.

Examine- lying in her bed, has had 75mg trazodone and 100mg gaba po this am, ate and had melox at 7-8 am.
MM pink, CRT 1s, HR 120, RR 24-28, chest sounds normal.
We supported her to get her up on her feet- can't walk with HLs or FLs, barely able to wt bear on the HLs at all and the FLs are also weak,with the RF knuckling over intermittently.
Slow CP both HLs, has sensation and withdrawal in HLs
Can't test her hemistanding/ hopping- just weak and falling when attempted. (this may be partially related to the morning calming meds she has had)
She did not react to palpation of the T-L spine but cried out when neck was palpated and extended.

Assessment: neck pain , with neuro deficits and weakness in FLs and HLs.
Discussed possible IVDD in neck, previous lumbar pain in 2024 (suspected IVDD then too, plain XRs of spine then did not show lesion, did not have advanced imaging, and it resolved with rest and pain relief)
Plan: we will take her to Killara for work up -start with bloods,  pain relief, GA and neck and lumbar XRs- advised the plain XRs may not be diagnostic and may require ref for CT/MRI to diagnose and may be a surgical candidate. Advised may need to go to NEVS o/n- Cath has just had foot surgery and can't drive but her son could transfer or collect dog later today.
 

03/03/2026 PCV: 48
TPP: 62
Plasma: clear
Cross-checked HCT/TP: 43.8/ 61
gsw/ap

usg: 1.046
AP

03/03/2026 AT sedation and radiographs:
Neck pain all directions, particularly extension R lateral rotation. 
Confirm proprioceptive deficits RF and delayed both pelvic limbs.
Withdrawal in tact
Suspect cervical myelopathy, lateralising to R.

Sedation
methadone 0.3mg/kg + medetomidine 10ug/kg IM 1:55pm
Catheter L cephalic v

Bloodwork:
- mild increase BUN
- creat normal 
- all else unremarkable

UA:
- USG 1.046
- 3+ blood
- pH 6.5
- 1+ protein
- rapidbac positive for gram negative --> send urine for C&S
---> start clav 250mg BID 5d

Radiographs:
- Spinal series - no obvious findings.

Recommend advanced imaging to further diagnose eg MRI or CT myelogram
Suspect myelopathy C1-T2