C09988207 / invoice 10000

HISTORY:
Usually very excited in the morning for walk, but this morning didn't want to get up - limping on front R leg. 
Was fine yesterday, has been previously very well. Sometimes has meloxicam for HL.

EXAM:
BAR
TPR WNL
abdo soft and comfortable
lame RFL - painful digit 5, nail and pads look fine

ASSESSMENT: Sore lateral digit RFL

PLAN:
O elected conservative managment
Recheck for rads under sedation if not improving

MEDICATION:
2ml methadone SC
Meloxicam SID PO for 40kg dog 7d
applied support bandage to protect toe 
strict rest 5-7days

COMMUNICATION: as above, discussed bandage complications, check twice daily

HISTORY:
Presented for: vacc
prev racing dog, prev MSK injuries
still on/off lameness with exercise, meloxicam as needed (but rarely)
started rosehip vital, glucosamine, mobility diet
appetite/thirst normal, no recent v/d+
UTD simparica trio
no other meds

EXAM:
Mentation: BAR, very anxious in consult
Eyes: NAD
Ears: NAD
Nose: NAD
Mouth: mild calculus generally, good teeth for a greyhound!
MM: pink, moist, CRT 2s
CV: HR: 120bpm, no m/a
Resp: rate & effort WNL, no crackles/wheezes
Abdo: tense
MSK: ambulatory all x4, no lameness observed, unable to perform full MSK exam due to temperament 
Integ: full, clean coat, ventrum NAD

ASSESSMENT:
Fit for vaccination

PLAN:
KC vacc SC between scapulae (B2430601 E06/26)
Disc OA management - environmental management, physio/hydrotherapy, supp, diet, weight managements, use of NSAIDs + additional pain relief, pentosan, beransa
Current OA plan: mobility diet, OA supplements, NSAIDs as needed, swimming
RV if mobility deteriorating 

COMMUNICATION:
As above. Adv to RV if any adverse SE noted, otherwise due for vacc booster in 12m.

HISTORY:
Presented for: DFW
were walking tonight, attacked by great dane on lead
few superficial wounds to chest
gave dose of meloxicam tonight
prev seen last week for lameness, resolved with NSAIDs/rest

EXAM:
BAR, very anxious
MM pink
HR 112bpm, no m/a
RR panting, no crackles/wheezes
Abdo tense
Ambulatory all x4, no lameness observed, tense on MSK exam but otherwise NAD
Clipped left side of chest to reveal superficial graze, surrounding skin moderately erythematous. Cleaned area with dilute chlorhex.


ASSESSMENT:
Minor DFW

PLAN:
Meloxicam 0.1mg/kg PO SID for another 3-5d
Keep rested
Can clean area at home with sterile saline, dilute betadine

COMMUNICATION:
RV if any concerns.