C09992258 / invoice 10000

MEDICATIONS DISPENSED: Iramine

Drug (Shelf) Name: Iramine 4mg
Volume/Number: 100 tabs
Label (Instructions): Please give TWO tablets morning and night ongoing.

Prescribing vet: MP
Revisit due: July 2026

PRESENTATION: Staging radiographs and ultrasound

HISTORY: 
- EDUD well, definitely improved since 'palladia holiday'
- nil V+ or D+
- Has RPL lameness every morning when he gets up but improves throughout the day
- Has pruritis and skin papules 
Current medication: Palladia mon/wed/fri, antihistamines SID

Examination of right hind limb: Pain not localised today, No CD
No lameness noted in consult.

ANAESTHETIC:
Premedication: (0.2)ml Medetomidine 1mg/mL + (0.5)ml Butorphanol 10mg/mL (IV/SC)

ACQUISITIONS:
Thorax left and right lateral, VD and DV
Right hind limb stifle CC and ML

THORACIC RADIOLOGY:
Ribs, vertebrae, sternebrae: WNL
Soft tissues of thoracic wall:WNL
Pleural space:WNL
Mediastinum:WNL
Heart:WNL
Trachea/principal bronchi: WNL:
Pulmonary vessels:WNL
Pulmonary parenchyma: WNL, no evidence of metastatic neoplasia found.

Right hind limb:
-Mild stifle effusion found. 
-Rechecked CD, not able to elicit CD.

RADIGRAPHIC SUMMARY:
-No metastasis found.
-Stifle effusion - concern over early CCL disease, no clinical evidence found. NO bone metastasis obvious today.

ABDOMINAL ULTRASOUND:

EXAMINATION:
Urinary bladder: WNL
Urethra:WNL
Prostate:not visualised
Kidneys:WNL
Adrenal glands: not visualised
Spleen:WNL
Liver:WNL
Gall bladder:WNL
Stomach:WNL
Small intestines: WNL
Large intestines:WNL
Ileocolic junction:WNL
Pancreas:not visualised
Free Fluid:0
Lymph Nodes:
- Medial iliac:WNL

INTERPRETATION:
-No metastatic disease found.

PLAN:
-Continue with Palladia and 3 monthly staging. To monitor lameness on right hind and reassess if not improving/re-radiograph at staging.


COMMUNICATION: