C10027147 / invoice 10000

Reason: Lame AsReason:Acute onset right forelimb lameness.History:Presents for right forelimb lameness which began last night. The owner reports Pippi was running around and jumping on the bed ("zoomies") prior to becoming acutely lame. She is now hobbling and non-weight bearing on the right forelimb.Pippi is otherwise well, eating and drinking normally.She was reluctant to go upstairs last night, which is unusual behaviour.Past medical history includes surgery on the right forelimb as a puppy for elbow dysplasia (removal of a bone fragment), performed at North Coast Vets (Sash). She experiences intermittent, low-grade lameness on this limb after exercise.She is on a grain-free diet. No known heart conditions.Examination:BCS: 5/9Demeanour: BARThoracic auscultation: Normal heart sounds, no audible murmur, HR - 110Normal bronchovesicular sounds, regular rate and effortMMs: pink, moist, <2sLNs: palpate WLNEyes: clear no dischargeEars: clear no dischargeOral grade: 1/4Abdominal palpation: soft and comfortable, no organomegaly or palpable massesIntegument: healthy coat.Musculoskeletal: Non-weight bearing lameness of the right forelimb. Outward rotation of the limb noted. Vocalised on palpation of the right elbow. Crepitus and joint effusion palpated in the right elbow.Neuro: no obvious deficits or mentation abnormalitiesRectal not performedRepro: desexedLaboratory:Not performed.Assessment:Acute flare-up of chronic right elbow osteoarthritis secondary to developmental elbow dysplasia.Acute synovitis of the right elbow joint.Client communication:Extensive discussion with the owner regarding elbow dysplasia as a chronic, lifelong condition that requires management rather than a cure. Explained that despite previous surgery, the joint remains abnormal and is prone to developing osteoarthritis and acute flare-ups of inflammation, particularly after high-impact activity. Discussed the examination findings, including the crepitus felt in the elbow, which indicates bony changes consistent with arthritis.Discussed multimodal management plan including:Joint supplements (e.g., 4Cyte).Prescription mobility diets (e.g., Royal Canin Mobility, Hills JD).Weight management to prevent excess strain on joints.Exercise modification: avoid high-impact, uncontrolled activities (e.g., jumping, running after balls). Encouraged controlled exercise like on-leash walking and swimming.Use of anti-inflammatory medication (NSAIDs) for flare-ups.Advised on signs of NSAID intolerance (inappetence, vomiting, diarrhoea) and to cease medication if these occur.Discussed referral back to a specialist (Sash) for further imaging (CT scan) and potential arthroscopy if lameness is ongoing or recurrent, but noted this is not an emergency.Discussed the importance of consistency with management to maintain quality of life long-term.Advised on strict rest for the next 5-7 days, including avoiding stairs.Treatment:Meloxicam (Metacam) dispensed for 5-7 days of pain relief. To be given with food.Consent has been given by the client to proceed with this treatment - YesPlan:Strict rest for 5-7 days.Course of Metacam as directed.Start on a joint supplement (4Cyte) or transition to a prescription mobility diet for long-term management.Re-introduction of controlled exercise after rest period.Re-check in one week or sooner if concerns. Can see us or their regular vet.Will forward history to Pridgeon Vet Clinic at owner's request.    Vital Signs