C09992446 / invoice 10000

Subjective:2 year old cat presenting with acute onset hind limb lameness. Owner noticed yesterday that cat is not putting weight on hind legs, sitting low to ground with tail tucked under. Cat attempted to jump onto kitchen bench day before and missed - unclear if this was cause or result of lameness. Cat is more lethargic than usual, ate dinner last night but not much today. Cat shows discomfort when owner tries to palpate HLs, but O unsure which leg is affected. Lives with 2 other cats, some chasing behaviour but not aggressive cat fights.Examine:Demeanor: BAR, very sweetBCS: 5/9Hydration: MM pink & moist, CRT <2sEyes: Open and comfortable. Full ophthalmologic exam not performed.Ears: No erythema. No malodour. No waxy discharge bilaterally. Responds to sound. No history of pruritus.Nose: No ulceration. No crusting. No nasal discharge. Oral exam: 1/4 - mild tartar, no gingivitis, quite a bit of gingivitis around 106 and 206LNs: Submandibular, prescapular and popliteal LN small, round, symmetrical. Integument: Shiny coat. No diffuse areas of redness, crusting or scaling noted. No obvious lesions/puncture wounds. Cardiovascular: HR = 180. No heart murmur or arrhythmia auscultated. Respiratory: No coughing. No sneezing. Clear lung sounds in all 4 quadrants. No increased respiratory effort. MSK: Marked hind limb lameness, hopping gait, sitting low to ground with hind legs tucked under. Seems to be taking weight off RHL slightly more than LHL but difficult to appreciate. No pain on palpation of digits, tarsus flexion/extension or hip extension bilaterally. Some resistance to right stifle extension. No obvious cranial drawer either stifle. CPs present. Hopping test HLs normal, visual placing normal. Neuro: Appropriate mentation. CPs present. Hopping test HLs normal, visual placing normal. Full neurological exam not performed.Assessment:Hind limb lameness - suspect RHL but difficult to localise - DDX: soft tissue injury vs CrCL rupture vs fracture vs other.Plan:1. Meloxicam 0.6ml PO once daily with food (contraindicated if vomiting/diarrhoea occurs)2. Radiographs under sedation scheduled for tomorrow - bilateral hind limbs and hips. Fasting from 9PM tonight, water removed tomorrow morning. 3. Strict rest advised in interim. 

Reason: NP Attacked By A DogAppointment Notes: O dog got a bit annoyed with cat and possibly bit it, cat seems painful, can't find any puncture wounds, told to come down if cat gets lethargic or worse / PFHistory: Possibly bitten by their dog Freya (a malamute). The two were playing and O gave Freya a treat. Gourmand went to eat the treat, and Freya tried to bite her. Gourmand went underneath Freya, then O didn't see what happened next. Didn't actually see Freya bite him. Afterwards he was subdued for a little while, hunched up and looked frightened. Has since improved and now seems back to his normal self. Walking around normally, no lameness or stiffness observed, no blood seen. He did have some saliva on the L side of his neck, but O couldn't find any bite wounds. Otherwise has been well. EDUF normal UTD with kitten vaccinations. Has been desexed. Examine: BAR, MMs pink/moist, CRT <2s, well hydrated No wounds, swelling, bruising, saliva or pain detected anywhere on palpation over body. No lameness, walking normally EENT, oral, skin, LNs, thoracic ausc, abdo WNL Assessment: No wounds found and NAD on PE. Can't entirely r/o internal wounds but hopefully unlikely (no bruising or bite marks found either). Ok to monitor at home. Plan: Monitor closely at home - if any concerns then recheck ASAP Next vacc due July next year. Updated reminder.