C10005826 / invoice 10000

Appointment Notes: Limping on leg. KF  ------- Sms reply: Yes History: Wednesday night got stepped on, Thursday morning screaming with HL stiffening/stretching outRHL stiffens and won't walk on it, screamsActing normally otherwiseScooting on her bottom -- did this a few months ago and found some mucus on her bottom Scooted again yesterdayDiet: FUSSY -- cooked chicken mince and steak and rice and veg, Blackhawk puppy kibbleFlea/tick: Nexgard Spectra UTDDeworming: UTD + tapewormerEDDU normally, no V+/D+   Examination: BAR, loves lamb treatsRHL MPL - Grade 2 -- does not spontaneously return to place in consultMouth - wnlEyes - wnl Ears - wnl LN's - wnl Heart - sounds and rhythm normal Lungs - clear Abdomen palp - unremarkable Skin - wnl Musculoskeletal - wnl Neurological - wnl Urogenital - wnl  Laboratory:  Assessment:Today's Concerns:Plan: - Consider x-rays of her right hindleg prior to surgery for her Medial Patella Luxation and to investigate for other problems that may affect her surgical outcomes.- Start Glandex chews for her scooting, we will express her anal glands while she is under anaesthesia for her x-rays. RV FOR GA X-RAYS AND EXPRESS ANAL GLANDS UNDER ANAESTHESIA ****GapOnly Insurance Summary:1. Primary / Suspected diagnosis: Medial Patella Luxation2. Suspect cause: Trauma?3. Date of first clinical signs (if known): 4/03/26Other conditions being treated (if any): Anal gland impactionKnown health concerns: none    Vital Signs    Weight: 4.1;       MMColour: Pink;       RespirationRate: 40;       HeartRate: 140;       Gingivitis: 0;       BodyScore: 4;       CRT: < 1 sec;