C10019123 / invoice 10000

Reason: Follow Up Discuss Scans Appointment Notes: cckp**Main Reason**Charlie presented for a follow-up regarding elbow issues. The client was sent information via email regarding elbow dysplasia.**Past Medical History:**The patient has a pre-existing condition of elbow dysplasia, where one bone in the elbow is longer than the other, causing a poor fit in the joint.**History:**** Current medications:**Anti-inflammatory tablets, which are difficult to administer. The owner crushes them with water and gives them via syringe.** Current Diet:**Royal Canin Satiety diet to assist with weight loss.Meals have been reduced from three to two per day.**Assessment:****[List of problems]**Lameness, particularly after rest.Pain and inflammation associated with elbow dysplasia.Overweight.**[Differential Diagnosis]**Elbow dysplasia.  The condition may be bilateral.**[Diagnostic plan]**Referral to a surgeon at James Cook University (JCU) for assessment.The referral will include current X-rays and all relevant file information.The surgeon will review the X-rays and may perform further imaging on the day of the appointment.Monthly weight checks to monitor progress of the weight loss plan.**Treatment:**Change anti-inflammatory medication from tablets to a more palatable liquid form.The liquid anti-inflammatory is to be administered on an as-needed basis for 4 days when limping is more pronounced, then stopped. If symptoms return, it can be given for another 2-3 days. This is to avoid long-term side effects.Supportive therapies discussed include low-impact activities, physical rehabilitation, and supplementation.**DISCUSSION AND PLAN**Discussed the diagnosis of elbow dysplasia with the owner. Explained that one of the forearm bones is longer than the other, leading to joint incongruity. Surgical options were discussed, including arthroscopy or osteotomy, with the final decision to be made by the specialist surgeon after reviewing the case. Information was sent to the client to provide a better understanding of the condition and potential treatments, which will help facilitate discussion with the surgeon.The importance of weight loss was emphasised as a critical component of management. The current diet and feeding plan were reviewed.A referral will be sent to JCU for a surgical consultation. Their team will contact the owner directly to schedule an appointment. Discussed that this is typically a day surgery. The new liquid anti-inflammatory medication was dispensed with instructions for intermittent use to manage flare-ups of inflammation and pain.Consent has been given by the client to proceed with this treatment - Yes.    Vital Signs