C10024296 / invoice 10000

Hi RachaelThank you for the referral of Lulu Winmill. I have attached my notes for you for the sessions she attended. Lulu would not allow a proper exam of her shoulders at any stage during her sessions. This is where I believe the largest portion of her discomfort to be coming from. I suspect there may be a soft tissue component. I discussed with the owner that diagnostics are indicated if you agree. They will make an appointment with you.Please call if you would like to chat.Kind regardsMonique 0474848101

recommendations from Monique - Will speak to Vet to consider CT scan or as indicated. We need more exact diagnosis.Lulu not compliant. Possibly best option CT at SASH and if shoulder tendonitisinvolvement they have shockwave for treatment.forelimb lameness worse on the left, Monique concerned re tendonitis, I'm also concerned for OSA if lameness getting worse quickly. pain in shoulders.owners keen to try beransa, but will proceed to imaging if lameness not improving/getting worse. 20mg beransa given sc. both dogs have had diarrhoea persisting for a few days. Bogart has biome food plus heaps of other stuff. recommended putting both dogs on biome only and pro-kolin. 

started coughing on sunday, now thursdayhas been fairly mild, retching type cough. didn't cough much at all yesterday but has done it more todaystill eating and drinking normally and still exercising - she went down the beach this morning.gums pink, couldn't see throat but did a sweep with fingers - no obvious FBheart and lungs sound normalt 38.6needing some more help with her arthritis. owners keen on trying laser so recommended Monique Crouch.dispensed meloxicam to help with the coughing, also to assess response with her legs. weren't impressed with cartrophen injections, didn't see much improvement. she is currently on antinol and CBD. also discussed beransa