C10010138 / invoice 10000

Reason: Sedated & X-Ray, nailsAppointment Notes: LH claiming through insurance. don't make her pay a deposit  ------- Sms reply: YesAdmit nurse: crh Sx nurse: trb Hospital/billing nurse: Amy Pre medStilator 0.5ml + Methadone 1.0ml @ 12:55pm ab/trb Reversed with 0.5ml @1:25pm TRBNOTES:3 x xrays taken under sedation- Lateral R stifle, lateral L stifle, VD view of hips and stifles.- R stifle appears to have mod increased opacity in joint space, arthritic changes seen. Was able to get some cranial draw under sedation in R stifle, grade 1 patella luxation. L stifle no cranial draw.Tx- More previcoxx for now - SID as neededDr LOH will have Dr STE asses xrays as issue has developed in the RIGHT leg which has had sx in past - cruciate sx done last year (August 2025)Nails clipped Skin a little inflamed today- especially around vulva. Recc cytopoint injections for skin in future if flare ups occur/dog seems bothered. Dogs teeth are very good with near to no plaque on teethPlan: Strongly recommend weight management to reduce strain on jointsMay need further sx, but need to consult surgeonOtherwise need to consider ongoing arthritis management.    Vital Signs    Weight: 33;       MMColour: pink;       Temperature: 39.4/stressed;       HeartRate: 100;       RespirationRate: panting ;       CRT: 1;