C10016771 / invoice 10000

Reason: O Advised Ambulance Will Be Here Approx 2pm NQHISTORY:O's presenting complaint(s): unable to stand From yesterday, unable to walk properly with hind limbs, dragging herself with the forelimbs, toileting in her bedding Not wanting to eat today and also had a vomit Distressed and panting/yelping when trying to walk History of progressive OA and trouble walking, requiring more frequent doses of loxicom and gabapentin Stilbeostrol for urinary incontinence Examine:PHYSICAL EXAMINATION: BCS: 5 / 9MCS: muscle mass wastageMentation: distressedEYES: NAD - clear, no noted discharge EARS: NAD - clear, no discharge, odour, erythemaNOSE: NAD - clear, no discharge, symmetrical, no lesions ORAL: pink but dry mm CARDIOVASCULAR - tachycardia, pulse pressures normal and synchronousRESPIRATORY: increased respiratory rate ABDOMINAL: tenseNEURO: absent patella reflexes on the left pelvic limb, present on the right, absent CPs on the left and reduced withdrawalMUSCULOSKELETAL: very reduced ROM of the left hip esp abduction, DJD and thickened joints RECTAL: not performedREPRODUCTIVE: externally normal INTEGUMENT: NAD - clear coat and skin LYMPH NODES: NAD - peripheral nodes palpate normal Assessment:1. Left pelvic limb paresis2. Acute on chronic DJD3. Inappetance4. VomitPlan:Offered screening bloods and radiographs to assess severity of situation and aid in prognostic guidance O not wanting her to suffer and given poor QOL factors (unable to rise to toilet, inappetance etc) elected PTS, offered home with additional pain relief tonight to give O little more time and housecall tomorrow, but O elected for this afternoon Received Methadone 1ml SC while waiting for other family members to arrive Pts outsideOwners presentDiscussion with owners re euthanasia procedureSedated with zoletil and acp SQAdequate sedation achieved in 5-10 mins with no deep pain responsePlaced iv catheter in R/L cephalic, saphenous veinAbsorbant pad placed under caudal ½ of patientLethabarb administered 0.5mL/kg slow iv to effectAftercare - Pet Angels collection    Vital Signs