C10020115 / invoice 10000

Reason: Change In Behaviour, Tail IssuesConsultation Time:History: - Concerns: unsettled behaviour, increased water intake recently not eaten for two days, diarrhoea and panting- History of presenting complaint:  - Recently went to the Lorry and was in and out of water.  - Chased another dog, which is unusual behaviour for Frank.  - Another dog jumped on Frank and then another dog ran into him and shook him.  - On return home, Frank was circling and then sitting down, then getting up again, appearing very unsettled.  - Increased water intake over the last two days.  - Has not eaten properly for two days.  - Owner reports unusual behaviour for Frank.Jumping when tail knocked and yelping Subjective: BARObjective: Temp not taken, unable to move tail out of the way without causing pain   MM  pk CRT  <2s  HR 156  FP=HRBCS:   7/9                       Wt: 40  kgPain Score (GPS:   13/24CV:  NAD       RESP:  slighlty increaed effort otheriwse NAD           RRpantingGIT:   NADU/G:  NADNeuro:  NADM/S:  NADInteg:  swelling approx 3cm caudally from tail base, VERY sensitive to the touch. Cries and leaps away. Ophth:  NADLNs: NADProblem List:Possible tail fractureAssessment: uspect tail fracture, close to the body.- Recommended diagnostic tests: X-rays of the tail to ascertain the nature and location of the fracture. Options Offered to Client:Rads tonight and admitPain relief tonight and r/v with reg vet --> O chose this optionTreatment:Methadone 0.2mg/kg IMMeloxicam (dosed on lean weight) 0.2mg/kg SCBandage placed to aid stabilisation of the possible fracture - reduced pain and actually able to lift up tail now. Plan:  - Advised to see a regular vet tomorrow for X-rays.  - Monitor for continued unsettled behaviour, changes in eating/drinking, or any worsening of symptoms. - Discussed potential complications of tail fractures, particularly those close to the body, such as incontinence and chronic pain if amputation is too short.  - Advised on the approach to tail fractures: some heal on their own with rest, others may require intervention depending on the type of break (e.g., straight across breaks are easier to bandage and heal than oblique fractures where vertebrae can slide).    Vital Signs    Weight: 40;