C09990066 / invoice 10000

Reason: Revisit HipsAppointment Notes: Special payment terms exist27/01/26 presetned bilateral hip OA, mild signs but clicking trial of carprofen  but stopped due to orange stools. Changed to Onsior 20mg SID.SUBJECTIVE:History: Lenny is a 3 year old dog who was presented today for recheck to monitor hip dysplasia. The owner reports Lenny had an episode of diarrhoea which resolved after stopping a previous medication. He was subsequently trialled on Onsior but developed a reduced appetite, which has since returned to normal after discontinuing the medication a week ago. The owner reports no significant difference in gait whether on or off medication. He remains high-energy and does not overtly display signs of pain. There has been one episode of vocalising in pain at home since the last visit. Doggy daycare has reported he is more playful. Paw licking has resolved following an allergy injection.Current medications: None.OBJECTIVE:- Vitals:- Weight: 14 kg- Physical Exam:- General Appearance: Bright and alert.- EENT: Conjunctiva are non-inflamed. No ocular discharge noted. The owner reports a previous issue with red, gunky eyes which have now resolved.- Integument: No evidence of active licking. The owner reports this has improved following an allergy injection.- Abdomen/GI: Normal.- Musculoskeletal: Ambulating well in the consult room. No obvious lameness.ASSESSMENT:- Stable bilateral hip dysplasia. The dog is coping well with current exercise levels without regular analgesia.- Recent weight gain is a concern and requires management.- Suspected medication-induced inappetence (Onsior) and previous gastrointestinal upset.- History of atopy (paw licking, conjunctivitis) which appears to be responsive to allergy injections.PLAN:- Diagnostic/Treatment Plan:- No surgery (hip replacement) is indicated at this time as the dog is functioning well.- Manage flare-ups with short courses of NSAIDs (e.g., Onsior) and exercise restriction, followed by a gradual return to normal activity.- Future chronic pain management could involve gabapentin if required, as it may be better tolerated.- Continue allergy injections as needed for atopy.- Recommendations:- Weight management is crucial. Advised to continue weighing regularly.- Diet: Continue feeding less than the feeding guide's recommendation for Prime 100. Suggested changing to a lower fat/calorie protein like kangaroo. Can supplement with low-calorie treats like carrots.- Exercise: Current walks of 2.5 km over 30 minutes are appropriate. Can gradually increase walk duration, starting with 45-minute walks intermittently before attempting one-hour walks, monitoring for any signs of soreness.- Hydrotherapy was discussed and recommended for muscle maintenance and weight control.- Owner knows to get in touch if any concerns or deterioration. A letter will be sent to the owner and the primary care veterinarian.Reason: RevisitHistory: No concurrent medical complaints reported. No recent vomiting, diarrhoea, coughing or sneezing. No recent weight loss or change in appetite.  No PU or PD reportedExamination:  BART:  , HR:   , RR:     , mm: pink, CRT: <2sHeart - nadLungs - nadAbdo - nadMusculoskeletal - nadNeuro - nadWeight - nadAssessment:Client communication:Plan: 1)2)3)    Vital Signs