C10016987 / invoice 30000

Reason: radiographs under sedationHistory: Persistent LFL lameness since Christmas day,Initially was intermittent, getting worse. Responsive to metacam. Owners have continued with controlled leash walking Procedure: Placed IV catheter in RFL,Adminstered 0.17ml medetomidine + 0.17ml butorphanol IVAchieved good level sedationExamination: Both RFL & LFL examined thoroughly by ES/KB/JN - nsfRadiographs: Elbows - lateral, flexed lateral and Cr-ca (both sides)Shoulders - lateral and AP (both sides) No significant findings on any of the radiographs.Plan: Recc continued conservative management;Another 14d metacam SID (reportedly tolerates very well) And strict(er) confinement - discussed. Avoid playing fetch, zoomies (no parkour off furniture), running, etc. Leash walk out to toilet only.Trazodone 100mg BID to assist with this. If lameness persisting after another 2 wks of conservative management,Recc referral to VSS for orthopaedic opinion.--- 11/03/2026 08:12:38 MFFuc, no answer left VM    Vital Signs    

Appointment Notes: Overdue remindersReason: GroomingHEAD: 5/8 inch combBODY/LEGS: 3fSHAMPOO:Nails & Ears Done.    Vital Signs    

Reason: Limping Front Leg - Same As Last Time - CNAppointment Notes: Overdue remindersHistory: Seen two weeks ago for L fore lameness, intermittent for 4 weeks before thatHad a really good response to metacam for just 4 days for L fore lameness and continued to be sound for about a week off meds, but has recurred.  Worming/Heartworm/Flea control status: UTDVaccination status: UTDNutrition: UTDExamination:COAT/SKIN: Clean and not inflamedEYES/EARS:  clean and clearMOUTH/TEETH: MM pink and moist, CRT 1 secHEART:  HR 116 no murmurLUNGS: Normal BVS all lung fieldsABDOMEN/DIGESTIVE/URINARY: Abdomen comfortableCNS/MUSCULOSKELETAL: Lameness is subtle.  O has determined it is after rest or exercise for about 10 minutes, then when she warms up she looks fine.In consult, is standing with the weight on the right fore and off the left.  No valgus deformity.Seems localised to elbow, especially on full flexion (doesn't mind extension).  However, she already resents all her feet being handled as well so harder to assess carpus and toes.  Hind limbs no issuesShe is very boistrousPERIPHERAL LYMPH NODES: WNLWEIGHT/DIET: Body Condition Score: idealREPRODUCTIVE: Assessment: Good response to metacam and rest but likely needs longer.  Ddx soft tissue injury vs elbow dysplasia etc.  Doesn't seem painful enough for panosteitis, no joint swellings and not shifting to indicate polyarthritisLaboratory:  Treatment: Discussed rads now vs longer on NSAIDs and rads in future. O is happy to try 2-3 weeks of meloxicam and reassess.  OK to maintain gentle lead exercise through this time.  Plan:--- 09/03/2026 4:17:05 PM RHW:Owner phoned to say Bobbi is still limping and wants to do the xrays tomorrow    Vital Signs    Weight: 15;       Temperature: 38.9;