C09992569 / invoice 10000

Reason: CHEMOTHERAPY appointmentAppointment Notes: Overdue remindersAssessment: Change in behaviour since she face-planted as she got out of the car last week, seems anxious. Yesterday was first time she started to look comfortable/run again. Gait exam: Can't say she is 'lame' as three-legged but especially when she first gets up she does seem to be moving her front leg stiffly and with reduced range of movement (not stepping forward as freely).Laboratory: Neutrophils at/just above level RB not happy to proceed with chemotherapy today, will wait a week and proceed then. RB offered we xray frontleg (R) to check there is nothing to be concerned.RB did not detect a pain focus on palpation before sedation. With sedation does not seem painful with extension of forelimb or pressure anywhere.Radiology: No significant findings.Radiographs attached to patient  file Anaesthesia: IVC site[ r cephalic ] size [  ]Butorphanol 10mg/mL[ 0.2         ] mLs @ [    ], Medetomidine 1mg/mL [     0.07    ] mLs @ [    ]Route of administration: SC / IM / IVMedications:Atipamezole 5mg/mL [   0.07  ] mLS @ [    ]  Route of administration: IM	Assessment: Muscular pain still adjusting/sprain or strain.Dispensed: Gabapentin, to see if improved gait.Plan: Next chemo in 7 days.    Vital Signs