C10027269 / invoice 10000

Reason: Lame On R Front Leg, Check Over Lumps Appointment Notes: BWHistory: ongoing intermittent lameness on RF; O out of metacoxx also. Seems worst after rest, but also can be bad even after a bit of running around; O notes was very good after a swim a little while ago. O also concerned re mass on belly skin, prev aspirated with inconclusive resultExamine: mass on ventral L abdo now around 14mm across (10mm in June 25), no deep attachment: monitor. Stiff in R elbow esp, no obvious pain elsewhere. Rest of dog looks OKAssessment: likely OA in R elbow, poss elsewhere in dog tooPlan: recommend X-ray RF (and LF) to rule out more sinister causes of pain eg tumour esp given size of dog. Discussed wt loss. Cont metacam; add paracetamol 500mg dailyRadiology: Site: Type of View: Sedation used: Premed and Anaesthetic Chart:Premed:Induction:Maintained on  Pain reliefFindings: x-rays confirm arthitis in both elbows, right greater than left. No sign of tumorPlan: NSAIDs etcDifferential Diagnosis:    Vital Signs    Weight: 45.1;