C10016908 / invoice 10000

Appointment Reason: Check Leg, berwick clyde vet, requested hxpossible Bilateral Medial Patellar LuxationS:  last few weeks intermittent lameness L hindO:  FAS 1/5, pink mm, teeth nad, chest nad, L hind muscle wastage quad, high grd 2 mlp l hind, no draw sign present, r side grd 2 mlp but not clinical at this stage, rest all fineA:  ddx:  bilateral mlp L>RP;  recommend sx - Tibial crest transposition +/- groove deepening est $3500-4000 depending on what needs to be done, L side first then observe if r side becomes clinical but chance it may need sx as wellbloods taken pre sx    Vital Signs    Weight: 4.05;       

Appointment Reason: 3rd VaccinationBIOP for 3 wks, already had 1st 2x puppy vacc. Has been well, owner has no concerns. Oral wormer given 23/3. Eating chicken hearts and Blackhawk puppy food.  O: BAR, nice pupEyes, ears, nose and mouth healthy, normal dental occlusion. Chest sounds and abdominal palpation normal, no hernias. Skin healthy. Neuromuscular exam unremarkableP: Protech C4 sc. Next Vaccination due 12mo.Proheart sc. Home with puppy pack. Rec spey at 6 months. Adv $540.     Vital Signs    Weight: 2.3;