C10014502 / invoice 10000

Appointment Notes: Temp 37.8 last nightHx: Has not been any better after the last 2 days of NSAIDsStill not wanting to interact with other dogs. Only walking a short way then will lie downNo lameness or pain or crying notedPanting was ok yesterday but then started up again last night and again this morning has been panting more. EDDU normal - no changes hereLast heat cycle 6-8 weeks ago O thinks but not quite surePE: Vitals all WNLNeurologically normal, normal proprioception but did stand with hind legs crossed once while in consultation?Very mild pain on plapation of L1-L2/TL jnBilateral luxating patellas - previous finding - no lamneness in consultation, no cranial drawerAbdo comfortableNomrothermicDdx:Most likely mild spinal change based on spinal pain and breed --> not yet severe enough for neurological changeVs other spinal change vs early pyo?Previous bloods 2 days ago cmpletely normalPlan: AFFAST and radiographs today. Discussed CT may be of more benefit esp if considering disk. O would like to start with survey imaging.Sedated 0.08ml medetomidine IV and 0.12ml butorphanol IV to good effectRadiographs:Area: spine, hips and stifles. Positioning: adequateArtfact: nilRadiographic Findings:- Severe congenital spinal abnormalities consistent with breed involving many types of hemivertebrae- Missing L caudal rib- Possibly some disk space narrowing @- Hip conformation OK, 50% acetabular coverage at this stage- Bilateral mild joint effusion stifles worse in the L, no cranial drawer evident. G3MPL L, G2 MPL RAbdominal ultrasound: NSF on ultrasound. Uterus 8mm dimaeter, no fluidNo free fluidAll organs look normalL adrenal gland normal, R not visualisedDdx: Most suspicious of mild IVDDPlan: Given normal neuro function - strict confinement + NSAIDs continue 2 weeks then reassessLong discussion regarding limitations of radiographs in terns of IVDD assessments - if worsens will require cross secitonal imagingAlso disucssed bilateral patellar luxation, worse in the L. On rads there is significant DJD present in the L stifle as well as joint effusion. No crnaial drawer evident on palpation but may be <5% tear. No cirrent lamenss so manage spine 1st but advised may require surgical intervention in the near future. Plan: RV 2 weeks, earlier if concerned    Vital Signs    Weight: 10.5;       MMColour: pink;       Temperature: 38.4;       HeartRate: 130;       BodyScore: 5/9;       RespirationRate: 28;       CRT: <2s;