C10024367 / invoice 10000

13/03/2026 
NURSE RP 

REASON OA + titre testing

HISTORY
- OA chat
- Trying to get her to use a ramp 
- Ox going away so would like her arthritis assessed + Synovan injection prior 
- Shifts position as if she's sore in HLs
- Check back teeth - Ox cleans BID 
- Titre test for vaccines requested by owner 
APPETITE: WNL 
ACTIVITY: WNL - goes for 3 walks a day 
DIET: Five hound 
TOILETING: WNL - no VCDS
CURRENT MEDICATIONS:
- Forthyron 200ug 1/2 tablet BID 
- Pawever plus - green lipped mussel 

CLINICAL EXAMINATION
Mentation: QAR
MM: Pink, moist
CRT:
Oral Exam and Dental Score: G1/4
Eyes: Clear
Ears: Externally clean 
BCS:
Lumps:
Abdominal palpation: Comfortable, slightly tense
Lymph nodes: WNL 
Heart Rate: 88bpm, no murmurs or arrythmias 
Respiratory Rate: 20rpm, normal respiratory effort 
Temperature:
Urogenital:
MSK: Slightly reduced ROM in hips (75%), knees feel stable, HL muscle mass even, comfortable in back
Skin:

ASSESSMENT:
- Healthy today

DISCUSSION:
- Discussed alternative pain management options: pregabalin (chronic pain, mild sedation possible), paracetamol (pending liver function), epiantodine (works on ketamine receptor, less side effects than NSAIDs, possible GI signs)
- Physiotherapy assessment available with Zoe if needed
- Discussed Synovan injection schedule - can do set of 4 every 6-12 months if needed

TREATMENT:
0.25mLs Synovan injected SC
Bloods taken for vaccine titre testing

PLAN
- Titer test submitted, results expected Tuesday
- Reassess in 4 weeks
- If doing well, push out injection interval
- If not responding well, can do set of 4 weekly injections
- Owner going away Wednesday