C09983927 / invoice 10000

REASON: RIGHT pelvic limb lamenessREFERRING VETERINARIAN: William @ Greencross MidlandHISTORY: Owner reports no current skipping observed. He is otherwise bright and active, though generally less active than when younger. No other significant health concerns. History of dental disease requiring multiple extractions. Previous episode of gastrointestinal upset (diarrhoea and inappetence) suspected to be associated with meloxicam following a dental procedure; has previously tolerated meloxicam at time of neutering.Gait: No skipping currently observed by owner.Medications: Previous meloxicam (possible adverse reaction on one occasion).Imaging: noneClinical Pathology: noneOther dog Oakley previously underwent bilateral surgery for medial patellar luxation and has recovered well, with improved weight bearing and increased activity. EXAMINATION:Gait: No lamneness observed during consultation.LEFT Thoracic Limb: NSFRIGHT Thoracic Limb: NSFLEFT Pelvic Limb: Mild reduction in muscle mass compared with RIGHT pelvic limb. Grade 2 MPL with free luxation and reduction. RIGHT Pelvic Limb: unable to luxate patellaASSESSMENT: Low-grade LEFT medial patellar luxation PLAN: Schedule LEFT medial patellar luxation surgical correction. Pre-operative radiographs to be performed on the day of surgery for planning purposes; CT not considered necessary. Surgery booked for 31 March with 08:30 admission. CLIENT COMMUNICATION: Discussed findings of low-grade luxation and recommendation for surgical correction given persistent instability. Explained that procedure is expected to be similar to previous surgery (Oakley) and that major tibial/femoral corrective osteotomy is unlikely based on examination. CT imaging discussed but not recommended due to low-grade nature and straight limb conformation; radiographs on the day of surgery considered sufficient. Discussed previous suspected adverse reaction to meloxicam; plan to avoid meloxicam and consider alternative NSAID. Admission time and booking confirmed. Owners invited to raise any further questions prior to surgery.    Vital Signs