C09999650 / invoice 10000

GAP pre-approval sent
CM 7 March 2026 at 10:08:20 am AEDT

HISTORY
Presenting for: Bruce, a 5 month old male Labrador presented for intermittent lameness of the right leg that has been ongoing for approximately1-2 months.
Diet: Good appetite - will stop limping when treats are offered
Current Meds: Up to date with flea and worming prevention
Other: - Lameness episodes resolve quickly but have been persistent over time
- When tired, holds right leg slightlyup with quivering noted
- Lameness sometimes present after waking
- Ran on beach yesterday which may have exacerbated condition
- Does not chew at the affected leg
- No lameness on presentation today.

EXAM
Mentation: BAR
Behavioural: Cooperative during examination, accepts treats readily
Musculoskeletal: Lameness localised to right forelimb. Discomfort noted on manipulation of right elbow and shoulder. Normal range of motion in both hips. Patient showed clear discomfort during palpation of right elbow area. Left forelimb examination normal for comparison.

ASSESSMENT
Right forelimb lameness - DDx: elbow dysplasia, shoulder dysplasia, growth-related orthopaedic conditions. Chronic intermittent nature and breed predisposition concerning for developmental orthopaedic disease.

PLAN
Diagnostics:
- Radiographs of right elbow and shoulder under general anaesthetic recommended within 1-2 weeks to evaluate for dysplasia
- Multiple views including extended and flexed positions will be obtained
- Radiographs to be reviewed by orthopaedic surgeon at Parramatta (no charge if available)
New Meds/Tx:
- Anti-inflammatory medication prescribed to provide comfort and assess response to treatment- home with oral meloxicam.
Additional Discussion:
- Elbow dysplasia can be difficult to diagnose on radiographs but multiple views and specialist review will optimise detection
- Response to anti-inflammatory treatment will help guide whether surgical or medical management is most appropriate
- Chronic pain may be present even when patient appears comfortable due to adaptation

Treatment plan given for radiographs, and sending through for pre-approval. O to call MB on Mon and let know response to melexicam, and book in procedure.

Presented for 16 week vacc

HISTORY: Going well at home. EDDU normally and BAR. Very excitable and likes to collect rocks and dig the backyard. Chews sticks and toys around the house. No concerns today. Due for flea and tick.

HR: 120bpm
Respiration: normal
Temp: \\
Vaccination Status:
   C3 Current
   Kennel Cough Current
Parasite Protection: 
   Flea control: Bravecto 1 month
   Tick control: ''
   Heartworm prevention: Proheart SR12
   Worming: Cazitel given in consult - however not due so zeroed out price
Skin: Good coat condition
Ears: NAD
Eyes: Clear and bright
Heart & Lungs: Strong and clear
Muscles: NAD
Bones & Joints: Good ROM
Teeth & Gums: Deciduous teeth starting to fall out, good occlusion
Intestinal and Urinary Health: Soft and comfortable
Body Condition Score: 3/5
Behavioural Issues: Nil
Recommendations: Wait 1 week before going into public spaces. Discussed monitoring for FB as breed are typical candidates. Desex after 12 months of age and maintain lean weight once an adult dog. 
Keep UTD with FTW and vacc again at 6 months 

JG