C09982858 / invoice 10000

Reason: Limping This MorningAppointment Notes: JMOverdue remindersHistory: Iroh is a 5 year and 5 month old male neutered miniature schnauzer presenting for limping. O reports Iroh LFL paw up this AM, woke up and not wanting to get up, usuallyexcited to walk, not interested tdayEAD well, noral toileitng  but limping LHL als shaky, not painful when O pressed paws Hasn't happened before Yesterday evening LFL paw up at end of walk, slow after that Otherwise well, not on any meds Limping this AM - which leg? Since when? Happened before? Otherwise well? EAD?Recc pain relief (metacam) + rest, INI recc rads Ruptured cranial cruciate ligament – cranial drawer + tibial thrustLuxated patellar – cranial drawerDiet + appetite: eating and drinking wellUrination/defecation: normalPreventatives: UTD NGS Any issues: no other concerns Examination: Demeanour: BARHeart: 100Resp: 30BCS: 5/9MM: p+m, CRT <2Mouth: C1G0, normal occlusion, no cleft palate MSK: slow, stiff ROMNeuro: normal mentation, no obvious cranial nerve deficits or ataxiaEyes: clear, normal menace response and palpebral reflex, responds to visual cuesEars: no erythema or lesions, not painful or warm on palpationAbdo: no pain on palpationInteg: clearLaboratory: TAHPAssessment: Ddx: soft tissue injury vs MSK injury vs OATreatment: Meloxicam 5 days Zydax inj (4 weekly inj to start, then monthly)Beransa inj (monthly)Antinol Rapid Paw Osteocare chewsCarprofen/previcox/robenacoxib/mavacoxibWeight loss dietConsent has been given by the client to proceed with this treatment - YesPlan:O to monitor, revisit if concerned Lose weight to take stress off joints    Vital Signs    Weight: 9;