C09986855 / invoice 10000

Presented for kinked tail. Owners noted the kink a couple weeks ago and she seems uncomfortable when touched around it 
no VDCS
EDUD fine
no lameness, no other sign of discomfort and normal tail carriage 


PE
BAR, lovely demeanor 
EENT wnl
pink mm and moist
dental stage 1
chest ausc wnl, HR 110 bpm
no skin lesions 
flinching and pain on lumbosacral spine palpation/hips 
no pain on tail palpation, no obvious fractures and displacements noted, however could observe the "kink" described by the owners". no integument lesions over the tail 


Discussed Xrays recommended to image for any tail fracture, however results of Xrays would not change tx approach that would be conservative at this time. O understood and consented to Xrays with preGA bloods. estimate was given during consult 

Xrays: no osseous abnormalities or displacements noted over the lenght of the tail. sacrolumbar spine wnl, no evidence of IVD dz. significantly decreased coverage of femoral head within acetabulum (R>L), indicative of hip dysplasia 


Discussed Xray findings with the owners. Recommended pain medication for the next 10-14 days and monitor. Discussed tail kink may be due to hip pain if Quinn is trying to "shift" some weight away from the RH. Discussed signs of discomfort associated with hip dysplasia, including, swaying, bunny hopping, reluctance to sit down or jump. Discussed changing exercise regime, favoring gentle leash walks instead of chasing a ball/off leash exercise, while continuing to keep her active. discussed importance of weight control and low/normal BCS.  discussed hip dysplasia is unfortunately associated with early onset OA which may significantly decrease her QoL as she gets older. Recommended to start 4cyte supplementation, fish oil and glucosamine chondrotin. Also recommended looking into physio and hydrotherapy. If medical management is not satisfactory, we can look into surgical options, with THR being the recommendation. 

Recommended NSAID therapy to manage ongoing pain flare ups (script on file). If on frequent NSAID administration yearly bloodwork is recommended 

TGH: carprofen 50-75 mg PO BID x10d 

Reason:  check face
History: 
noticed grass seed stuck onto the face today
was bringing her for a walk and came back to find it stuck on cheek

Current medications: none

What Preventative health cover is being used and do you need to purchase any today? due for vacc

Examine: 
Mentation: BAR
Body condition score: 3/5
MM: pm               CRT: 1-2 sec
HR:  110            RR: panting
LN: WNL
Temperature: NA due to P's compliance to keep still

Ocular: nad
Oral/Dental stage: 1
Ears: nad
Cardiovascular: no murmur noted
Respiratory: clear lung sounds
Gastrointestinal: soft and comfortable on palpation, no obvious organomegaly noted today
Integumentary & lumps (measurement, location): grass seed lodged on RHS cheek
Musculoskeletal: nad
Urogenital: nad
Neurological: nad

Problem List:
grass seed on RHS cheek

Assessment: 
brought P to tx room, clipped fur and removed grass seed that is lodged on RHS cheek with forceps
fit for vacc

Treatment: 
MSD C4 + BBoral
batch number: 2524002//2516202
annual vac due: KC1 2026

Plan: betadine clean bid for 3 days. Monitor at home for any swelling, told O cannot guarantee if any more grass seed left in if its fragmented etc. If notice swelling on the face to RV. May need sedation/GA for grass seed exploratomy

Please note:
Weight is based on the phone call IP had with owner as she was asking about desexing cost and wanted estimates for this.