C09984816 / invoice 10000

Reason: Sore Leg, Revisit Night Noises (Cb)Appointment Notes: Overdue remindersHistory: Presented for lamenessNew neighbours moved in with young dogs and Cammi has been fence runningYesterday became lame on LH leg, and is still lamen todayLives on monthly synovan and carprofen 20mg SIDHas had cruciate surgery on RH in the pastStill makes strange sounds at night and hacks up mucus occasionallyExamination: BAR, HR wnl, BCS 5/9, DS 3/5Msk exam - grade 3/5 lame on LH, on examination painful on stifle manipulation, possible cranial drawer although is quite tense and resistingAssessment: Suspect ACL - full or partialTreatment: Trial pain relief and rest, increase carprofen to BID for 3-5 days and can add paracetamol as well (written instructions given)Buprenorphine inj given for todayPlan: If lameness persists recommend sedate and xray - can also check back of throat at the same timeDiscussed options for surgery vs concervative care - owner expressed no cost constraints and would like to do what is best for Cammi    Vital Signs