C09989314 / invoice 10000

Student: Jasleen Bath & Zen Yeng Yeap Reason: Left Hind Holds Off Ground When RunningAppointment Notes: Overdue reminders  ------- Sms reply: YReason: Lameness of HL, licking HLsHistory: Played with 7mo German Shepherd dog on Saturday and yelped. Client suspects Nyx hurt himself (is sure the GSD did not injure him) Monday went on excursion.Morning walk today, kept looking over his shoulder towards the one side; only wanted to go home- unusual behaviour.Usually go on long walks.Hx of sensitive stomach. Examination: EDDU: eating & drinking as usual. Scooting once today before d+ D+/v+: 2x today had d+ (unable to pick up). No v+ Couhging/sneezing: none Diet: Dry food (gut & skin). Prime 100 (on day trip- then very flat on the next day) Vax: UTD Parasite control: Symparica due today Laboratory: Assessment: Very friendly, excited to greet people. BARHR:   120bpm        RR: 36brpm       MM:        CRT:           FP:  SSBwt: 9.2kgLNs: Normal. BCS:                  MCS: Temp: 37.7*CMSK: All 4 limbs ambulatory. No obvious lameness or ataxia. No muscle asymmetry. - FL- range of motion normal across all joints bilaterally - R HL- range of motion normal across all joints. - LHL- slightly luxated on the knee joint. All other joints range of movement normal.- No obvious patellar luxation. Normal range of movement of hip.Integument: Slight erythema on L plantar aspect of the foot, particularly between digist 2 and 3.Rectal exam: R side slightly enlarged anal gland which was expressed. L side around pea-sized (normal). Eyes: Ears:Oral:CVS: Sinus rhythm with synchronous pulse. Resp: Abdominal palpation: Mildly distended with gas. Neuro: All 4 limbs ambulatory. No obvious lameness or ataxia. No further investigation warranted.Anal tone: Assessment: Suspect mild cranial cruciate ligament disease.Mild distension of GIT- ddx Treatment: 1) A few days of strict rest2) Trazadone 150mg per tablet- 1/2 a tablet BID or as required. Do not crush the tablet.3) Meloxicam 1.5mg/kg Options offered to client 1) Psyllium husk 1/2 tbsp BID- care with constipation if overfeeding fibre. 1) Radiographs of both knees under GAPlan:Client is aware that orthopaedic exam was performed to test for cranial cruciate ligament rupture. Client is informed that dogs <15kg have fairly good success rate for cranial cruciate ligament ruptures with just conservative management (75% success rate)Client is adviced that often if one leg is affected,the other leg is likely also affectedA few days of rest and anti-inflammatories.Offered sedatives. Radiographs of the both knee under GA- swelling would indicate joint effusion and Cranial cruciate ligament rupture. Would also help rule out fractures. (Estimated $1000) To stabilise the joint 1) Bandage2) Surgery- insert artificial ligament or    Vital Signs    Weight: 9.2kg;