C09982681 / invoice 10000

Appointment Reason: Medical Check + Cartrophen History:- health check for OA/DJD- generally okay- xrays for heart + arthritis check - no v+/d+- no change in thirst & urination- mobility: when walking is very clicky, lost muscle strength in HLs- on hip + joint supplements (fish oil + healthy bones hip & joint supplemnt) + cartrophenDiet: beef broth + broccolli, cauliflower, sweet potato, spinach + blueberries + Supercoat senior dry Current problems: OA/DJD + gr1-2 heart murmurCurrent medication: cartrophen qmonthlyExamination:BAR, lovely girl, won't take treatsEyes - mild bilateral SNSOral - moderate tartar on upper caninesHR - 120, gr2 L systolic murmurMSK - ambulatory all 4 limbs, easy to sit when back touched & increased paniculus response through lumbar area, mild reactivity to lumbar spinal palpation, NAD on tail jack or lumbar dip, crepitus in LHL digits repeatible & reduced ROM in RHL hip full extensionIntegument - small 2mm area of alopecia on LFL lateral carpusAssesment:OA/DJDHL paresis + lumbar spinal pain ddx worsening OA/DJD vs spondylosis vs IVDD vs othergr2 L systolic heart murmurPlan:cartrophen given 0.7ml given SC, next due in 1 month. O wanted full dog xrays but discussed about prioritising chest xrays + lumbar + hip & HL full xrays as they are the problem areas & NAD seen in FLs today. Estimate given, O already booked for this    Vital Signs    Weight: 23.6;