C10003794 / invoice 20000

Reason: Physio & HydroAppointment Notes: Worming aswell and please send home worming and bravecto for scooby CEWHistory:- Referred for hip dysplasia, muscle atrophy in hind limbs, and gait abnormality- Double hip dysplasia noted, severe for his age- Exhibits an adapted gait and trembling of the hind legs- O reports- Daily walks for an hour, weekly visits to a farm and occasional visits to a dog park or beach- Significant arthritis diagnosed at age one- Anxiety noted, especially in new or unfamiliar environmentsExamination:Hind limbs: Weakness on the right side, muscle atrophy noted globally Hips: Double hip dysplasia with associated arthritisGait: Abnormal, described as a funky walkMuscle: Spasms noted in the thoracolumbar region during examination- Hip dysplasia- Muscle atrophy- Arthritis- AnxietyTreatment:PEME to reduce joint inflammation and provide sedative effectsLaser therapy targeted at hips to reduce pain and inflammation, and prevent arthritis progressionPlan:Strengthening exercises focusing on quadriceps and gluteals to stabilize hipsIntroduce hydrotherapy  to strengthen muscles around the hip to help stabilise the joint disuseShorter, more frequent walks advised to reduce strain on hipsRecheck and introduction to hydrotherapy scheduled for next weekHome exercises prescribed: sit to stands (6 reps, morning and night), lateral weight shifts (8 reps, morning and night), and paws up weight shifts (3 reps daily- hold for min 7 seconds)    Vital Signs    

Reason: Tahp Results Back Appointment Notes: Overdue remindersLaboratory:  URINE SEE inhouse lab tab for automated UACreatinin is muscle breakdown probably from the hips Urine is adequatrely concentrated Plan: Get into physio    Vital Signs    

Appointment Notes: 4 cyte granules large packet GGOrdered 23/2  4cyte Sacret 100 gm SK    Vital Signs