C10014065 / invoice 10000

Reason: O Thinks Broken Back Leg? - ROOM 9Appointment Notes: possible fall/jump off high bed, only noticed this morning, didn't see incident, didn't get weightConsult Time: History: Acute onset nonweight bearing lameness this morning. Was fine last night, zooming around. O thinks might have fallen off bed, plays rough with other dog at home as well. EDDU normal, otherwise no concerns/ Subjective: QAR, toe-touching on RHLObjective: Temp: 38.8            MM: pink              CRT: 1-2             HR: 160             FP: strongCV: no audible murmur, pantingRESP: increased effort, lungs clear on auscultation but difficult to hear clearing through panting             RR: pantingGIT: comfortable on palpationU/G: no palpable bladderNeuro: normal mentation, no obvious neuro deficitsM/S: unreactive to lumbosacral palpation, resistant to manipulation of RHL, but tolerates flexion and extension. No reaction of palpation of joints, no patella luxationInteg: good coat qualityOphth: no inflammation or dischargeEstimate of approximately $1100 for 3 view radsAssessment: acute onset RH lamenessPlan: Offered admit for sedated rads, or option to trial pain relief. Advised physical exam findings are not typical with fractures, usually much more vocal and reactive to palpation.Owner elected medication trial, will book in for rads if no improvements by Friday. Recommend trying to rest and keep quiet for next 3-5d. Treatment: Consent has been given by the client to proceed with this treatment  -  YesMethadone 0.1mg/kg IMMetacam 0.1mg/kg PO SID    Vital Signs    Weight: 4.45;