C10018702 / invoice 10000

11/03/2026 NURSE: MH
HISTORY: Doing well but hind legs getting progressively worse especially on floor bioards & concrete. Legs went out from underneath her the other day.
EDFU - Normal except for fecal incontinence.
-Diet: Savor life mobility dry & wet.
-Env: Indoors & outdoors.
-Comp: 1 other dog.
-Prev: Not up to date.
Current Meds: Meloxicam 2.1ml SID, Gabapentin 400mg BID, Beransa 30mg & fluoxetine 20mg.
-Insurance: Yes, Medibank
SUBJECTIVE: BAR
OBJECTIVE: T=  MM - Pink CRT <2sec HR 124 = FP RR: Panting RESP: Clear
BEHAVIOUR ASSESSMENT: Nice but anxious.
BCS: /9
GIT:NAD
U/G:NAD
NEURO: weak hindlimbs. 
M/S: pinful hips, lumbar spine, 
reluctant to sit, pacing. 
muscle atrophy
SKIN: mild scurf
OPHTH:nulear sclerosis
OTIC: -
LYMPH/N:
ASSESSMENT: osteoarthritis. - poor quality of life
Tx OPTIONS:
TREATMENT: Beransa 30mg(batch#813179 exp: 05/2026) & ketamine 0.2ml SQ
PLAN:
DISCUSSION: Talked RE: Pain management options. Quality & end of life talk and questionairre
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DISCHARGE
We have seen Muggles for her 6 monthly health check today. We have given her beransa injection & we have also added in a ketamine injection for added pain relief to help her feel more comfortable. As ketamine can make some animals a little drowsy so please keep her nice and quiet today. She can have the ketamine monthly but if she is not doing well she can have it as frequently as weekly. As it is a controlled substance these appointments need to be with a vet. 
We have discussed quality of life and you have a quality of life questionnaire to consider whether its time . You can call us and request more medications , just let us know what size bottle you would like
You can use paracetamol 500mg ( 1 tablet) twice daily for pain as well. We discussed liver function and possible issues but are treating her palliatively so elected no blood tests for this. 
 If you have any concerns or queries please do not hesitate to contact the clinic