C09994507 / invoice 10000

Reason: Tripped Up Stairs Yesterday, Now Is SoreAppointment Notes: Overdue remindersHistory: Yesterday slipped through the gap at the back of the stairs. Off her dinner last night. Keen to go on her usual walk at 8pm last night. Seemed stiffer morning and seems stiffer after lying down. Has spent most of the day just lying in her crate. This afternoon happy to go out on a walk. Lame on LH?Clinical Signs: QAR. Very nervous. OMM pink. Dental grade 2/4. Eyes nad. HR 128. Heart nad. Resp nad.AP tense. Peripheral ln's nad. RT 39.7Gait: narrow based hind legs with a mild sway to hips, occasionally drags LH paw. When sitting was holding up LF. LF: resents extension of elbow. Carpi, shoulder nad. No swelling of carpus. RF: nad. LH and RH poor rom hips. Resists extension. Legs the same length. Stifles and hocks nad. Stiff with pressure down TL spine. Appears uncomfortable. Strong resentment of neck ventroflexion and turning teh Neck to right and ventro.Can hemiwalk both sides. CP present but slow - think nervous and reluctant not neurological. Assessment: 1. Pyrexia. Ddx - stress, inflammation, infection. No swelling of small joints to make highly suspicious of IMPA. 2. Resents manipulation of hips, L elbow and neck ventroflexion and turning to the right. Ddx resenting hip manipulation = back/spinal however would not expect keen to go on walks or to be worse after lying down. Plan: Treat for soft tissue soreness after fall through the stairs. Meloxicam 0.1mg/kg po sid with food for 7 days. Paracetamol 250mg po bid. INI and still pyrexic suggest CRP.    Vital Signs    Weight: 10.9;       

Reason: Lepto BoosterHistory: For vaccination todayOn bravecto and drontalOwner giving " a tablet" for "other things" - asked to call MVH to specify as I am unsure from record of HWPClinical Signs: BAR, thoracic exam NAD, MM pink, T=NTreatment: Nobivac lepto s/c Owner to check preventives at home    Vital Signs    Weight: 11.3;       

Appointment Notes: Overdue remindersHistory: No owner concernsNo V/DNormal EDUFO unsure if UTD with preventitives.Had 1 stillborn with a litter with Tamaruke, hasnt had regular seasons.SOC not happy with tamaruke situation, but has not made a fuss.Clinical Signs: Examined on table- shaking ++Eyes ears NADDS 1-2/4, mainly upper canines.Heart/lung uasc nADNAD abdo palpAssessment: Fit for vaccMicrochip scanned and is in SOC's name, so is her legal decision to desex or not.I would also be willing to write behavioural exemption for breeding/veterinary reasons to desex. Treatment: Bb/pi inj SC1st lepto 2 inj SCPlan: Cont prevntitivesRecommend dental + desexing (have explained why we dont do these at the same time)2nd lepto 2 inj 4wks    Vital Signs    Weight: 11.3;