C10003391 / invoice 10000

Appointment Notes: VETSTORIA  Jessica Southwell (0457855720 jessiev1986@outlook.com) with Walter (Dog) - Consultation - Single issue (Discoloration to abdomen/general check up) - [Veterinarian : Dr Kirrily McWilliams (Preferred Clinician)] -  Web BookingClient name: Jessica SouthwellContact number: 0457855720Email address: jessiev1986@outlook.comPatient name: WalterPresenting Complaint: Walter presents for discoloured patch of skin to left of prepuce Patient History:- Recent weight gain due to decreased exercise tolerance from left stifle pain- Left stifle intermittently painful, limiting walk distance (limping by time end breakwall walk)- History of patellar luxation, previously noted by a veterinarian- Some days better than others for mobility- Sits with affected leg tucked under, or splays out on tummy- Ears doing well with regular Cleans Ear drops, groomer instructed not to pluck ears- Current diet: half cup kibble (Optimum adult) plus cup of wet food daily, occasional treats- On NexGard Spectra (up to 15kg)- Occasionally given meloxicam when very painful, recently ran out, would like some more- Vaccination overdue (last done over one year ago), Jess happy to update todayAss:Healthy and fit for vaccinationOverweight. Need to reduce food intake. Cut out meatballs. Feed only the dry food in 2 daily meals. If not losing weight by scheduled rads, consider metabolic diet.Skin slight change from exposure or licking, not really concerned. Of more concern is LHL lameness. Too young to be frequently this lame and reliant on regular metacam. Appears to be from MLP but recommend rads and assessment under GA to confirm. Jess happy to do. ES may be happy to do surgery here? Ok to use metacam up to and after surgery.Needs a teeth cleanRx:Protech C4 s/cOral BB    Vital Signs    Weight: 14.5;       MMColour: Pink;       RespirationRate: 28;       HeartRate: 120;       HeadEyes: Normal;       Nose: Normal;       Skin: Abnormal (10cm diam patch of skin on L side ventral abdomen is slightly more pigmented than contralateral skin. Skin appears healthy. );       MusculoSkeletal: Abnormal (R gr 1 MLP. No pain or reaction to manipulation at all. L Gr 3 MLP. Pain response on light manipulation. No cranial drawer but didn't pursue as is painful. Poor hip extension. );       Ears: Normal (Very hairy but appear healthy. Will check with otoscope when in for rads);       Neck: Normal;       LymphNodes: Normal;       Heart: Normal;       Lungs: Normal;       Abdomen: Normal (Limited by obesity);       RectalGenetalia: Normal;       Demeanour: BAR;       Hydration: Normal;       Gingivitis: 1;       Calculus: 2;       Observation: Normal;       BodyScore: 8;       DentalGrade: 2;       CRT: 1-2;