C09983289 / invoice 10000

Reason: MPL Xrays & Assess Cruciate Appointment Notes: ajs - pre ana emailedHave discussed case with TW so TL and TW can both have a look at!History: RH  intermittent lameness Grade 3/4 luxating patella Laboratory: Pre Anaesthetic Blood Test including CBC and SDMABlood taken to run test in house.CBC: Biochemistry: mild low globulins, mild low ALP Treatment: IV catheter placed right cephalic Premedication methadone 0.3mg/kg and medetomidine 10ug/kg IM IV catheter placed right cephalic Flow by O2Alfaxan TIVA to effect Orthogonal pelvic limb radiographs - R stifle grade 3 MPL  Likely due to shallow medial trochlear ridge   Patella appears to track straight through joint   No distal femur deviation   Minimal swelling/joint effusion - Left stifle stable and patella difficult to luxate - Hips & spine nsf- Minimal CD/TT both stifles Assessment: RIGHT stifle MPL grade 3/4 +/- stable partial tear Recommend RIGHT MPL surgery and starting OA management. MPL surgery:  Trochleoplasty + lateral imbrication (TTT likely unnecessary but will evaluate at time of surgery)Will assess for cruciate disease when visualising joint   Discussed radiographs, MPL surgery +/- TPLO, complications and recovery with owner. Discussed surgery at WAVS vs referal to specialist surgeon. Plan:Estimate given for MPL sx +/- TPLO Book in when TW return from holiday end of March    Vital Signs    Weight: 7;