C09990425 / invoice 10000

Reason: RecheckHistory: Managing really well.Hip dysplasia and suspected iliopsoas tendinopathy initially presented lame L > R.Will still sometimes bunny hop when excited or moving at faster paces.Otherwise, up to walking 5.0km.Was a little tired after a longer walk but not lame.Assessment: Enjoying massage.Presented for lumbar massage today - triggers still found at TL junction.Not lame in clinic today.CB mentioned also haven't been as disciplined with exercise program.Considering holding off on surgery for now.Plan: Continue with MassageSit to stand on a slope (5) 3High reach - back legs on disc (20)High reach with side stepping.Keep walking and enjoying activities - returning gradually to normal routine.    Vital Signs    

Reason: Recheck History: Has been doing well.Will slow down on the longer walks.Regularly managing 20 minutes but further and ending with a hill isn't so great.Not limping as much.More engaged in the clinic today.Assessment: Working well for beef jerky treats.Able to tackle new challenges - harder exercises.Engaging core well.Nose to tails, would be better if had hip stabilisation.Drop-stretch - is not a drop-crawl.Plan: Add inHigh reach on a step or an unstable surfaceFigure of 8's with an obstacleBackwards walkingSit to stand on a slope - back end facing downhill    Vital Signs    Weight: 16.2;       

Reason: Inital ConsultationHistory: Over the last 18 months, O's have noted hindlimb lameness.Particularly associated with over exertion, and ball play.Last episode not sure what the inciting reason was.Xrays show hip dysplasia - flattened femoral heads bilaterally, increased osteophytes on femoral neck L > R.Anxious dog by nature.Would take treats in the clinic, but something spooked her half way through the consultation and then wouldn't take treats from the hand after that.Assessment: Good symmetric muscle development.Triggers in lumbar spine and mid spine - TL junction.Lats also triggers.Sits with legs folded to L side, nearly all the time at rest, however can sit straight when concentrating.Can position in a sphinx but will roll legs to L side if holding for a long time.Complete physical exam not performed due to temperament, wanting to stay in positive space.Even then went over threshold and couldn't recover.Would not approach the hurdle at all.Possible iliopsoas mechanism injury or tear.(Lumbar vertebrae very 'flat' on xray.)Plan: Start core and back strengthening program.MassageSit to stand (5)3High reach over an obstacle (20)Drop-stretch(5) : stand and reach (1) x 3Nose to tails (5) each side.Return to lead walking, starting with 10 minutes BID and building up slowly from there.    Vital Signs