C09987633 / invoice 10000

X-rays

limping & very stiff (lameness of right front leg)

Surgery

Normal heart sounds and rhythm CRT 1.5s MM p/m normal pulses

Bloods taken for gen health,  - NSF, slightly increased  phosphorus- ? significance 

Established IVFT with Hartmanns

Premed: (1.0mL) methadone and (0.15mL)  domitor IM
Induced with (4.4mL) proprofol  IV
Intubated with (10.5mm) CETT and maintained on iso and O2

x rays of left and rigth fore leg:
(lateral and flexed elbows ), lateral shoulders, Crcd elbows

no obvious pathology seen- though advised to send x rays off for radiographic interpretation

limping & very stiff

Subjective:
- Limping and stiffness in front right leg following incident few weeks ago
- Yelping heard from outside, unknown cause
- Managed with rest initially
- Physical exertion exacerbates symptoms, comes in lame after activity
- Chronic vomiting occurring at least twice daily, usually after eating or drinking
- Vomiting present since early age, not improving as dog grows
- Not eating rapidly, grazes throughout day
- No paw licking or ear scratching currently
- Born via caesarean section due to maternal complications


Exam:
BAR
EENO:NAD
Normal heart and lung sounds
HR: 102
Musculoskeletal unremarkable
Temp: not taken
Lymph nodes:wnl
Abdominal palp:nad
MM:pm crt 2s
No lameness while ambulating.
BCS: 5/9


Ddx:
1. Chronic vomiting: Primary GIT vs Extra GIT causes
2. Right forelimb lameness: Soft tissue injury vs developmental joint disorder
3. Stertorous breathing


Tx:
1. Refferal to veterinary nutrionist for novel protein diet trial + Blood test
2. X-rays forelimb under GA + gabapentin trial. No meloxicam due to chronic vomiting.
3.  Check airway/soft palate while under.

Plan: Owner to book in