C10009124 / invoice 10000

Reason: Limping, Left Back Paw AdPrimary Presenting Complaint:Non-weight bearing lameness left hind limbOther Complaint:OverweightHistory:Previously monitored for cruciate ligament issues. Recent history of digging with shards noted in environment.    - Last Normal - Yesterday - reluctant to walk but ambulatory    - Frequency - Progressive lameness over 24-48 hours, now non-weight bearing    - Microchip - Y/N - scanned - ok?Examination: Overweight dog with acute LHL lameness secondary to ulcerative paw lesion requiring bandaging and analgesia        - Musculoskeletal - LHL digit 2 distal pad ulcerative lesion, painful to palpation. No foreign material visualised on examination. Rest of limb comfortable. Historical cruciate monitoring noted. No pain involving the rest of the leg.   Assessment:Problem List:1. LHL digit 2 distal pad ulcerative lesion - painful, non-weight bearing2. Overweight (13.9kg)DDx:LHL digit 2 distal pad ulcerative lesion:- Traumatic injury (most likely given acute onset and digging history)- Squamous cell carcinoma- Mast cell tumour- Foreign body penetrationDiscussed:Owner consented to treatment plan including bandaging and meloxicam. Discussed possibility of more sinister pathology such as SCC or MCT, though traumatic aetiology considered most likely given acute presentation and history. Advised that if neoplastic, would not necessarily pursue aggressive treatment immediately but would monitor response to conservative management first. Owner has meloxicam at home but unclear of concentration, so dispensing practice medication for clarity. Instructed on need for e-collar if licking/chewing at bandage. Advised strict rest. Owner understands need for recheck in 5 days. Weight management briefly discussed.Treatment Plan:Protective bandage applied to LHL paw covering digit 2 ulcerative lesion. Home with meloxicam 14kg  or 0.9ml PO SID for 5 days for analgesia. Strict rest advised. E-collar if interfering with bandage.Ongoing Prescriptions:Next Visit:Recheck in 5 days for bandage removal and wound reassessmentThe above clinical notes were created with the assistance of Astro Scribe under the supervision of the consulting Vet.    Vital Signs    Weight: 13.9;