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Reason: s/yCT:20.00 x Gabapentin 100mg Give one capsule TWICEa day Dr Suzanne FaragLiverpool Veterinary Hospital329 Hume Hwy Liverpool - 0296026015    Vital Signs    

Reason: C/uAppointment Notes: ------- Sms reply: YesPATIENT:LunaFrench BulldogWeight:Reason: Recheck right hind limb lamenessHistory:Luna is a French Bulldog presented today for recheck to monitor right hind limb lameness. The owner reports putting more weight on the limb over the last two days. Previously was non-weight bearing on the right hind limb. Suspected ligament or muscle injury.Current medications: Gabapentin one dailyExamination:Vitals:Physical Exam:    - Musculoskeletal: Right stifle examined. Previous findings noted - coxofemoral changes on right side, possible stifle involvement. Rachel noted effusion on right stifle; Andrew unable to visualise effusion on imaging review.ASSESSMENT:Right hind limb lameness - suspected stifle pathology. Andrew does not believe hip is the primary problem. If cruciate ligament is intact, patella will be addressed; if cruciate ligament is partially torn, this will also be repaired.PLAN:Diagnostic/Treatment Plan: Continue gabapentin one in the morning and one at night. Rest and pain relief if limping recurs. If no improvement with conservative management, will proceed directly to surgical exploration of right stifle with Richard - will assess cruciate ligament integrity and address patella +/- cruciate repair as indicated. No repeat imaging planned prior to surgery.Recommendations: Monitor for recurrence of lameness. Continue restricted activity.    Vital Signs    

Reason: PhoneO reports that the leg is getting worseLuna is now putting no weight on legBut is still active and O is finding it difficult to settle her down to prevent further injuryTelephone conversation SF spoke to Simone advised about the Radiographic finding SF will send RADs to be assessed by Dr Andrew Levien and Dr Rachel Saba for assessment regarding surgical plan3/3 Dr Rachel response Hi Suzanne Thank you for your email and I hope that you are doing well Luna has a bilateral stifle effusion and hip dysplasia (with a pretty mis-shapen right hip). It would be unusual to have a new lameness associated with the hip alone, so I wonder if she has an early cruciate. Can you luxate her patellas? I think to be certain it might be worth recommending a surgical consult, which can either be at VSOS or mobile. This is a case where I would correlate the radiographic findings with your physical exam. I hope that helps and have a great day, Rachel    Vital Signs