C09981564 / invoice 10000

Cartrophen Injection LS

Since last seen, it seems that cartrophen hasnt made a huge/obviously noticeable change. However patient has been held back from the extremely lively activity that he would otherwise engage in - eg constant activity - chasing flies etc. Has previously been running at the beach etc - so a lot of excercise. Owner reports that Storm was bred as a working dog. 

Ongoing current  issues - hind legs giving way intermittently and LFL lameness. LFL lameness-  when this occurs - at times he even holds his paw up and doesnt want to use his leg. Then it seems to improve after a little while. 
no other concerns.  This occurs a few times each day.

Exam - QAR HR 130 rr 20 temp 38.8 mms pink crt not possible. 
Oral exam with owners help - grade 2-3 calculus on caudal upper PM4 + M1 visible. Muzzled for rest of exam as owner advised this would be best. 

LFL intermittent mild lameness. 
Hind limbs looks a bit weak, splaying laterally at times mild-mod amount. Foot placement on proprioceptive tests was wnls. 
Forelimb proprioception - nad. 

Stiff on attempted extension and abduction of left shoulder and left hip (mild-moderate). 

Ddx - osteoarthritis, muscular pain from overexercise +/- neurological component/myopathy. 

Blood results are within normal limits. Reex in 2 weeks or sooner if concerns. 
 

4th Cartrophen Injection booster LS
0.8ml cartrophen given Ls in waiting room. Storms likes kang treats. O thinks storm is doing better but hard to tell. O booked in for another cartrophen injection in one months time 

3rd Cartrophen Injection booster LS

No real improvements yet 
very stiff when starts moving after rest but then walks out of it

given 08ml injection SC in scruff, Storm jumped back and so needle came off and squirted out mid injection. topped  up with naother 0.5ml SC in R flank - no issues. 
Last injection in 1 week, then could start repeat injections every 3 months and assess progress.