C09996679 / invoice 10000

Reason: ArthritisHistory: Doing better since on Amoxyclav course and codeine syrup. Still doing his usual cough but not as much as when he had a flare up and went to VSOS Will still cough everytime excited etc O here today due to declining mobility. Last had synovan course  2023.  The past year had declined a lot, slipping and dragging Examination: mentation appropriate.Ears nose WNL Grade 3-4 dental- marked halitosis, only able to see the canines and premolars Coughing in consult Swaying and dragging RHL consistentlyLimtied ROM on both hips. Marked muscle loss on both HL RHL- proprioception reduced. Withdrawl reflex present. Deep pain present LHL- proprioception WNL Laboratory: Assessment: O not sure how long he's been dragging but just thinks he's declining a lot Discussed neurological finding- might have lesion along the spine > rec strict rest vs referral to VSOS for possible imaging O would like to monitoring weekly whilst coming back for synovan inj with a vet.Discussed Synovan vs Beransa. O opted for no Beransa when trying to explain the bad rep of beransa in the media Treatment: Synovan #1 0.25 ml SC Consent has been given by the client to proceed with this treatment  -  YesPlan:Synovan #2 in 1 week with a vet Please check gait and neuro    Vital Signs    Weight: 8.3;