C09985556 / invoice 10000

Rehab follow up

Subjective owner assessment since last visit:
 has been resting well since the last visit. She has not been allowed outside except on lead for toileting and has been taken for short walks up the street. She has been okay overall but is very bored with the restricted activity. The owners have noticed that when walking, she seems to twist her foot, whereas the other foot is not doing anything. This is mild but noticeable. . Today she had a very nasty bowel motion just before leaving, which is the first time this has occurred. Bowel motions had been progressively getting softer but today was significantly worse. No diet changes have been made in the last week.
was subdued after the last visit, appearing tired and relaxed. 

Medication:
Loxicom. Advised to cease medication until diarrhoea resolves, then restart at half dose once tummy is settled, and gradually increase back to full dose after a few days. If diarrhoea recurs, cease medication altogether and an alternative NSAID will need to be trialled. A 5/7 washout period is required before starting a new NSAID.

Previously/Currently Affected Areas:
Right stifle suspected CCL injury. 

Physical Examination:
Mild swelling noted right stifle, appearing slightly puffy compared to the left. Trembling observed during examination. Head turning noted when starting to become uncomfortable. Gait assessment reveals twisting of the right foot during ambulation, with the left limb functioning normally. Sloppy sit posture observed with right hindlimb positioned out to the side, indicating reluctance to flex or extend the right stifle.

Treatment:
Shockwave therapy 0.63mJ/mm² 4/6 x 2000 shocks to both stifles. Shockwave therapy 0.63mJ/mm² 4/6 x 2000 shocks to both hips. Laser therapy 45J/180s to right stifle. TENS 5Hz 160us burst mode x 30 minutes to neck. Acupuncture performed.

PLAN:
X-ray booked for tomorrow morning at 9:30-9:40am with Dr Nicole at yarraBilba to rule in or rule out cruciate ligament injury. Owner is leaning towards proceeding with surgery if cruciate is confirmed. If surgery is required, aim to schedule as soon as possible after return from Lennox Head on Friday. If surgery proceeds, wait 2/52 post suture removal before recommencing physiotherapy for optimal outcome. Will contact to touch base and follow up on progress. 

rehab report attached