C10026727 / invoice 10000

Reason: Hind Limb LimpingAppointment Notes: Add microchip to fileStarted a day or two ago (~8/3) DAHistory:  Has lost weight but still overweightMore exercise recently and he comes up sore at times esp after more exercise and then stiff after restOtherwise ok. No known injuryPossible hips? Maybe right side? Examine: Mentation: BAR, not happy with some parts of exam, growls but does not attempt anything. Peripheral LN: NSFOral: MM pink, moist. CRT<2sEyes: Eyes clear, no redness or discharge. No evidence of pathological ocular changes on external exam. Full ophthalmic exam not performed. Intact palpebral and menace response both eyesEars: Ears clean. No evidence of inflammation or discharge on external exam. Otoscopic exam not performed.Cardiovascular: Heart rate 140. No murmur or arrhythmia on auscultation. Pulse quality good and synchronous.Respiratory: RR and effort WNL. Lung sounds clear all fields.Gastrointestinal: Abdomen soft and non painful on palpation. No obvious organomegaly or abnormalities. Rectal exam not performed.Ugen: NSFInteg: NSFMSK: Ambulating well, no obvious lameness. Does very slightly bear less weight on RHL with occasional tremor on RHL. NSF on MSK exam, but does not allow full exam.Neuro: NSF, normal mentation. No spinal pain Temp: not taken Assessment: Suspect some degree of OA secondary to breed/conformation, weight.Ideal weigh 20-23kgPlan: Carprofen 50mg BID for no more than 3-4 days on flare up daysCan also do paracemtaol 250mg to 375mg BIDContinue weight loss planAdd on 4cyte Consider Active Pet Rehab for hydrotherapy    Vital Signs    Weight: 26;       BodyScore: 7/9;       

Reason: Weight Loss / DietAppointment Notes: Paws App Details:Booking Type: New Client/PetBooking Vet: - Any -Booking Notes: We would like to consult a vet to put Wallace on a prescripted diet to aid in weight loss. Checked - BAHistory: - Has always been on the heavier side ever since young- Eats 2 cups of Vetologica kibbles, and 120g of frozen meat packet from Costco - Aware that he is overweight - O's other dogs had hip replacement, elbow arthroplasty etc due to overweight; so would like to proactively keep Wallace - No PU/PD- Panting and exercise intolerance due to weight and will snore as well Examine: Mentation: BARPeripheral LN: WNLEENO: NAD Teeth: 0/4 Cardiovascular: no murmurs or arrhythmiasPR = HR 120Respiratory: no adventitious lung soundsGastrointestinal: soft and comfortable abdo palpationMusculoskeletal:  normal gait, full msk exam not performedIntegument: no lumps or bumps, skin and coat in good conditionUrogenital: WNLAssessment: Overweight Do not think there is any endocrine disease Treatment: None Plan:Commence Hills Metabolic diet 2 cups per dayTarget weight 20kg    Vital Signs    Weight: 29;