C10003122 / invoice 10000

Reason: Chronic neck painHistory:(Neck pain related - vet record)27/01/ 2026 - episode of Left forelimb lameness/ thought to be related to interdigital inflammation, no neck pain. Started pred course for possible inflammation - V+ episodes during the course and look lethargic.28/ 01/2026 - recheck with no other significant findings, left forelimb seem to be weight bearing more and normal ambulatory - however still deemed to have mild chronic pain, started a short 5-days course of meloxicam 0.1mg/kg SID PO.06/03/ 2026 - recheck for change in demeanour and pain, which owner thought mildly improved with last meloxicam course. Mild reaction to neck palpation, with reasonable neck ROM, still occasionall lift up left forelimb. Gladsville vet restart the meloxicam course with concern of pain related neck disc extrusion.Current medication: - Had last dose of meloxicam yesterday afternoon with food; V+ out undigested food right after. In daily meloxicam for around 2 weeks. - Keppra TWICE daily.- LosecOther medical Hx/ comobidies- Controlled partial seizure episode - last recorded dose of medication: levetiracetam 187mg PO q8h. hepatopathy resolved with phenobarbitone withdraw- Chronic vulval skin fold dermatitis - suspect hyperadrenocorticism (atypical HAC) - none clinical- Abdo u/s on Nov 2024 - 2 small hepatic nodules with  plump adrenal glands (5.5mm average pole diameters) - last dental procedure at 12/2025, D+ episode post-procedure but self resolved.Intermittent pain/ stiffness at the neck since early December (since Lily, the other dog passed). Seems to response to meloxicam.Trial liquid paracetamol but does not seems to help, tried 50mg gabapentin and it caused profound sedative.Subjective:BAR, normal mentationObjective:RR:Panting, MM: pink, CRT <1sNeurological examination: Assessment:Treatment:Plan:MRI coming Thursday - continue on gabapentin 100mg and 0.9ml paracetamol twice daily until then. Skip the morning dose of gabapentin and one dose of keppa at the day of procedure.    Vital Signs