C10003716 / invoice 10000

TIME: 8.08AMVET: SOMHISTORY:Playdate with dog yesterday.Had a bit of limping last night. Now whining and will not let o touch the LFL foot.Looks like the foot.No vxx, dxx.No coughing or sneezing.Still acting well.Eating fine.Drinking.Current meds: NoAllergies to meds. Prophylaxis: Vaccinated and wormed.Pre-existing conditions:No heart or renal disease.Has had FB in bowel in the past.TRIAGE:HR: 110RR: Chest fine all quadsTemp: 39.1CMm: pink and moistCrt: 1Mentation: BARPain Scale (0-4): 1/4Hydration status (%): goodEXAMINATION:Body Condition Score: 4/9Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings, no cranial nerve or proprioceptive deficits/gaitMusculoskeletal: has lameness in the LFLRest of legs ok.Sl reaction to hips but also did not like to WB on the LFL when HL up.Gastrointestinal:- Oral: normal, no mouth pain, dental score (1-4):  nice teeth- Abdominal: no detectable pain on abdominal palpation, normal gut soundsComfortable in general.Urinary: NSFReproductive (incl ext genitalia): NSFIntegument/Ears: aside from foot (seen notes)Lymph Nodes: peripheral lymph nodes normalEyes: NSFLFLHolds the foot up when walking. Quite lame.All of ROM of wrist, elbow, and shoulder fine.No issues with nails or toe pads.Toes ok and no pain on ROM.Only sites of pain:Main WB pad: pad has a little flap of skin off (1mm) of medial pad.This is associated with swelling.COULD be FB in place or something that has gone in and come out.Also sore on distal MC 3 (? Referred pain from the WB pad or could be a separate issue like a crack if the dog got foot stuck somewhere like a fence)PROBLEM LIST:Only sites of pain:Main WB pad: pad has a little flap of skin off (1mm) of medial pad.This is associated with swelling.COULD be FB in place or something that has gone in and come out.Also sore on distal MC 3 (? Referred pain from the WB pad or could be a separate issue like a crack if the dog got foot stuck somewhere like a fence)DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Possible penetrating wound on WB pad.Could be FB in it?Or just cellulitis.TREATMENT:500mg BID clavuloxBupreorphine 0.8ml Metacam 2.5mg SID.If not improved - needs rads of foot and also explore of the WB pad with own vet.O to photograph the pad so we know where the initial hole/flap of skin was.    Vital Signs    Weight: 27.9;