C10003050 / invoice 10000

Reason: Unable to Stand Up?Consultation Time: 09/03/2026History:Psembi presented this morning for an acute episode of ataxia and collapse. The owners observed him by the door after he got out of a room. He moved towards a window and then lost control of his body, described as "spazzing out" and shaking. This led to concerns about a possible seizure or poisoning. He also experienced some urinary incontinence during the episode. He was wrapped in towels and brought to the clinic immediately. Upon arrival, he was able to stand, which was an improvement from the initial state where he was unable to support his own weight and his legs were splaying out to the side. The owners report that in the last three days, Psembi has had significantly more exercise than usual, running and jumping on multi-level hills at a new dog park. There is a history of a broken front left leg as a puppy, involving the growth plate, which was treated with a cast. This leg can become tender after exercise. A few weeks ago, he had an infected nail surgically removed by the RSPCA but has been off all medication for some time. Appetite and drinking habits were normal last night. There has been no vomiting or diarrhoea. The owners mentioned a local park where other dogs have reportedly been poisoned with baits, but this seems less likely given the lack of gastrointestinal signs. They also reported giving him a very small amount of leftover lamb with a marinade that may have contained minuscule amounts of garlic, but this is not thought to be a significant concern.Subjective:Quiet, alert, and responsive on presentation. Was initially shaking, which the owner reports is normal for him at the veterinary clinic or in the car due to anxiety. He settled during the consultation. Appeared to have some difficulty weight-bearing on his back legs initially when walking in the consult room.Objective:Temp: 38.7°C MM: Pink CRT: <2 seconds HR: 100 beats per minute FP: Strong and synchronousBCS: 6/9 Wt: 6 kgPain Score (CSU): Not assessedCV: No murmur or arrhythmia.RESP: Normal bronchovesicular sounds, no nasal discharge, normal respiratory effort.RR: 28 breaths per minuteGIT: Comfortable on abdominal palpation. Rectal exam not performed.U/G: NAD.Neuro: Appropriate mentation. No neck or overt back pain identified on palpation and manipulation.M/S: Ambulatory, though appeared weak on the hindlimbs initially. Full range of motion in all limbs on examination. There is a history of a fracture in the front left leg as a puppy, which can become sore with exercise. No plates or pins were placed.Integ: Normal haircoat.Ophth: Pupils equal and appropriate.LNs: Palpably normal.Problem List:- Acute onset of ataxia, collapse, and muscle tremors.- Mild urinary incontinence during the episode.- History of increased physical exertion over the past three days.- History of previous left forelimb fracture.Assessment:The clinical signs are most suggestive of an acute, severe musculoskeletal pain event, possibly secondary to over-exertion, leading to significant muscle spasms. A neurological cause, such as a pinched nerve in the cervical or spinal region, is a differential diagnosis that could explain the generalised nature of the signs affecting all four limbs. Given the significant improvement without intervention and the normal physical examination findings, a primary musculoskeletal cause is considered most likely. The presentation is similar to severe back spasms seen in humans following unaccustomed strenuous activity. Poisoning is considered less likely due to the absence of vomiting or other typical signs.Treatment:Carprofen 20 mg tablets were prescribed.Plan:Diagnostic plan:If the clinical signs recur or fail to resolve, further diagnostics could be considered. This may include imaging such as radiography, although this is more useful for bony abnormalities. A computed tomography scan would be an option for investigating soft tissue or neurological issues if it becomes an ongoing problem.Therapeutic plan:Administer carprofen 20 mg orally once daily with food for five days. The first dose can be given this morning. Strict rest is recommended for the next three days. This involves no off-lead activity, no running, and only on-lead walks for toileting purposes. It is important to enforce rest even if he appears to feel better on the medication.Discharge plan:Re-examination with his regular veterinarian is recommended in 2-3 days (Thursday or Friday) to ensure he is progressing well, with normal appetite, hydration, and toileting, and no recurrence of neurological signs or incontinence.Client Communication:Discussed the likely cause being severe muscle spasm secondary to over-exertion. Explained the treatment plan involving pain relief and strict rest. Advised on how to administer the tablet to a fussy eater, such as hiding it in a small amount of palatable food like ham, cheese or chicken. Cautioned that large amounts of cheese can cause gastrointestinal upset. Also advised that minuscule, one-off amounts of garlic are unlikely to cause issues, but it is best to avoid feeding foods prepared with onion or garlic, especially chronically. The owners understood the plan and recommendations.Discharge InstructionsPsembi presented today following an acute episode at home where he collapsed, was unable to stand, and had muscle tremors and some urinary incontinence. This occurred after a period of increased, strenuous exercise over the long weekend. On examination, Psembi's vital signs were all normal, and he did not show any specific areas of pain on palpation of his neck, back, or limbs.The most likely cause for this episode is a severe muscle spasm due to over-exertion, similar to how humans can experience debilitating back pain after intense activity. Other possibilities, such as a pinched nerve, were also considered. We have chosen to manage this presumptively as a musculoskeletal issue.The recommendation is to treat Psembi with an anti-inflammatory pain relief medication (Carprofen 20 mg) once a day for five days. This medication must be given with food. For home care, it is crucial that Psembi is kept under strict rest for the next three days. This means no running or jumping, and he should only be taken outside on a lead for toileting. Even if he seems better on the medication, he should not be allowed to exercise, as this could cause re-injury. We recommend a follow-up appointment with your regular veterinarian in two to three days to monitor his progress.    Vital Signs