C09992670 / invoice 10000

Reason - GA/ rads and assess legs. Pre-op check- See prev consult. HR NADPremed acp / meth sc. Induction alfaxan iv. iso maint. Palpation under GA-Stifles- Unable to luxate patellas. No Cr draw, tibial thrust or effusion/medial buttress.Hips- Both hips have reduced ROM.L hip ortolani POSR hip ortolani NEGElbows - NADHocks- Hyperextension both hocks. Rads- Lat and CC stifles- NAD. No effusion/ inflamm or degen changes seen. Elbows- NAD. No evidence of elbow disease, degen changes. Hocks- NADHips- Both hips are severely sub-luxated with the L hip 25% and R hip 10% DAR coverage. R hip has more 2o remodelling and OA/ osteophytes. Poor DAR formation. PLAN- Consider specialist opinion on hips / referral to specialist surgeon?May not be a candidate for DPO/TPO. Maybe THR?Regardless of this strongly recommend starting life-long OA management eg synovan, 4-cyte, joint protective diets? Weight and exercise management. JJS discussed findings and plan in detail. Owner wants to think about everything before starting treatment plan. Gave synovan and 4-cyte brochures.     Vital Signs    

Appointment Reason: Limping, Appointment Notes: looks like knee is clicking. O doesn't think he is in pain so doesn't want to bring him earlier...OMOngoing 'abnormal gait'. See prev consult initially picked up around 3mths ago. O describes as swaying and ankles look abnormal.Still happy and playful. Growing well. Not under or overweight.BAR/ friendly and lively. Gait exam seems to swing out hind legs a bit (hippy gait). When standing tends to shift weight onto forelimbs causing the hocks to hyperextend.When standing or sitting forelimbs held very close together and paws externally rotated. Exam- Forelimbs- Bilateral elbow effusion. Some discomfort noted in elbows on full ext.  NAD shoulders.HLs- Very little response anywhere. Maybe some reduction in ROM in hips? Not clearly painful though..PLAN- admit next week for GA/ palpate and rads.Will need to screen elbows, hips, stifles and hocks.Est ~ $1200    Vital Signs    Weight: 31.5;       

Appointment Reason: Vaccination, Appointment Notes: TTCoughed for 3-4 days then was fine Well & eating O thinks Chico has a funny gait - showed video & certainly is a little skip at canter No lameness,Doesn't slow him down Palp hips & stifles & all feels ok but he is a bit stiffWill be getting him desexed in next 4-5 months , so recc X-ray hips & stifles at same timeDo on JJS day & do admit with Jon so can show him videos Rest of PE unremarkable Fir for first adult vx Given Duramune C4 ( 5260011 Exp 30.10.26) BB oral (5245046B Exp 9.10.26) Not getting regular HW & Maia get injections Given 1.6ml Proheart ( 703582 Exp 07/2026)     Vital Signs    Weight: 31.7;