C09992526 / invoice 50000

Methadone/acp premed.Ga and xrays:Hips - look okayStifles - look okayElbows - look okayR shoulder - looks okayL shoulder - OCD lesionRecommend referral for Sx at AVC.    Vital Signs    Weight: 48.7;       

Not lame today, but has been intermittently lame on LFL. Glennis says lameness doesn't stop dog doing anything and he doesn't hold leg up at all.On exam, dog actually quite timid/anxious today and was growling at other dogs in waiting room.  Does not get out of property much, so hasn't had much exposure to "life"since PPS.  Some mud dried ventral aspect paw.  Nad on palpation digits or carpus.  Normal ROM with no resistance on exam of elbow nor shoulder.At previous visit in Dec, VH localised soreness to shoulder.  Dt age & breed, recommend xrays of elbows & shoulders under ga.  Booked in next week.Dispense loxicom to use as needed.    Vital Signs    Weight: 48;       

Reason: LameLF lameness after playing rough with his brother in the backyard. Otherwise well, EDDU normally, no V/D/C/S. Not on any current meds. TPR normalGait- grade I lameness LFMusculoskeletal- no obvious fx/dislocation/crepitus palpable. Repeatble pain response around shoulder joint, restricted ROMSuspect soft tissue injuryExercise restrictionReassess in a week, INI, will require x ray under sedation    Vital Signs    Weight: 40;       Temperature: 38.1;