C09981749 / invoice 10000

Reason: HC - RSClient Present:Vacc's O'dueNurse:EGKat acquired Noodles in Nov from friend who has moved o'seas.She has had a trainer come to her house to do a behavioural assessment as Noodles has been growling when picked up and/or touched in the abdominal region.O has declined vaccines today & is not UTD with FTW.He is edud and O has no other concernsHealthy Pets Wellness Testing: Done Yes / NoVaccination Type:declinedIntestinal worming:not utdHeartworm Prevention:^^Flea Prevention:^^Tick control: Not current. Discussed the high risk of ticks in the area and recommended starting prevention such as Nextgard Spectra. Will send information to the owner.Microchip: on fileInsurance and Healthy Pets Plus:Behaviour concerns: Growling, particularly when the owner's daughter attempts to pick him up. Has been ongoing since adoption in November. Currently working with a dog trainer. Possesses a jealous and dominant temperament with the husband.Current medications:Current Diet: Receives dental treats (green crocodiles) which cause an upset stomach. Pig ears are tolerated well.Type of Shampoo/Frequency: Unable to brush due to matted coat and apparent pain. Grooming is deferred until pain is managed.Toileting:History: Adopted in November (four months ago). Presented for assessment of growling and a possible underlying medical cause as suggested by a dog trainer. History of being in a previous home with three boys. Owner has noticed a change in gait, described as less confident and not as fast as usual. Growling has been present since adoption. The dog displays pain responses when being brushed due to a matted coat.Examination:Demeanour: Bright, alert, responsive. Vocalised during examination.Temperature:not takenHydration Level: Adequately hydrated. Mucous membranes moist. Skin tent appropriate.Eyes, Ears, Nose, Throat: Eyes clear. Ears are clean and non-inflamed. Oral mucosa is pink.Capillary Refill Time/Mucous Membranes: MM pink, CRT <2 seconds.Oral exam/Calculus level (0-4): Calculus score 0-1/4. Minimal staining present. No tartar build-up or broken teeth. Gums appear healthy.Cardiovascular/Heartrate: HR: 80 bpm. No murmur auscultated. Pulses are strong and synchronous.Pulmonary/Respiratory: Lungs clear on auscultation. No abnormal respiratory effort.Peripheral Lymph nodes: WNL.Abdominal Palpation: Soft, non-painful.Urogenital: Male.NeuteredRectal:normal externallySkin/Integument and Nails: Matted coat. Unable to be brushed due to pain.Musculoskeletal/Neurologic function: Abnormal gait noted, swinging from the hips. Right hindlimb appears stiffer than the left. Reluctant to have hindlimbs extended. Pain response noted on palpation of the hip region. Palpation of the back was tolerated well. Unable to assess for patellar luxation. Jumps up without apparent hesitation.Muscle Condition: WNL.Pain Score (0-5): 2/5Laboratory: Recommended radiographs of the hips under sedation to definitively diagnose the cause of pain.Assessment:1.  Musculoskeletal pain, likely originating from the hips (right greater than left). Differential diagnoses include hip dysplasia or other orthopaedic conditions.2.  Behavioural issues: growling, resource guarding/jealousy. Likely exacerbated by pain.3.  Matted coat secondary to pain on brushing.Treatment: Discussed initiating a trial of pain relief with meloxicam (an NSAID). Advised on potential side effects (vomiting, diarrhoea) and to cease medication and contact the clinic if they occur.Consent has been given by the client to proceed with this treatment - yes.Plan:- Dispense meloxicam 5mg/mL liquid. To be given once daily with food for 3-5 days, then as needed pending response and further diagnostics.- Provide an estimate for hip radiographs under sedation. Discussed this may cost approximately $900.- Advised to restrict strenuous exercise initially.- Postpone grooming until pain is managed. If he responds well to pain relief, he would require this before a grooming appointment.- Client is continuing with a behavioural trainer. Positive reinforcement techniques are being implemented.- Will email owner with information on tick prevention and the estimate for radiographs.- Re-evaluate based on response to pain relief. Long-term management may involve joint supplements if there is a good response. Discussed that even if a surgical issue is diagnosed, medical management is often an option. Follow up to be arranged to discuss progress.    Vital Signs    Weight: 7.5;       HeartRate: 88;       DentalGrade: 1;       RespirationRate: panting;       PainScore: 2;       Temperature: not taken;       CRT: <2;       MMColour: pink;       BodyScore: 5;