C09970263 / invoice 10000

Reason: Dew Claw Bleeding - Painful/shaking.PantingTIME: 13:20VET: GNHISTORY:Tried to get into chicken pen, ripped dewclaw nail RHSmall amount bleedingVery anxiousTRIAGE:HR: 120RR: pantingTemp: n/tMm: pink moistCrt: 1-2Mentation: anxious but friendlyPain Scale (0-4): 1Hydration status (%): 0-5EXAMINATION:Body Condition Score: 5/9Cardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory: thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: neurologically no significant findings Musculoskeletal: ambulating normally, dewclaw nail on RH torn at baseGastrointestinal:- Oral: normal - Abdominal: no detectable pain on abdominal palpation, normal gut soundsTREATMENT:Removed  nailBandaged footPLAN:Leave bandage on for 24hrsCan have 500mg Paracetamol if painful    Vital Signs    Weight: 32;       

Visit Vet: Dr Sara BaileyVisit Vet: Dr Sara Bailey-------------------- Fees Charged: --------------------Item Code: 132158 Item Name: Metoclopramide 5mg/mL Qty: 3.250Concentration: 5mg/mlItem Code: 572 Item Name: Apomorphine 6.5mg Tablet Qty: 1.000Item Code: 150875 Item Name: Emesis Qty: 1.000Item Code: 149650 Item Name: Consultation - Saturday Qty: 1.000    Vital Signs    

Visit Vet: Dr Sara Baileynote details from 2023-11-04:REGULAR VET: {__}AES VET: Sara BaileyTIME: 23.30REASON FOR PRESENTATION:ate chocolate icingHISTORY:ate chocolate icing at home - brought in for emesisCURRENT MEDICATIONS:nil medications or supplementsEXAMINATION:Mentation: BARCardiovascular: no murmurs or arrhythmias - HR 132Respiratory: normal lung sounds all fields, no discharge from naresBody condition score:  7/9Weight: 32.5kgAbdo: soft and comfortableMusculoskeletal: ambulating well x 4 limbs. ortho exam not conductedNeurological: appropriate mentation and ambulation in clinic. full neuro exam not conductedEyes/Ears/Skin: NADUrogenital: NADLymph nodes: WNLHydration/volume status: euhydrated, euvolemicPROBLEM LIST:chocolate ingestionASSESSMENT and DIFFERENTIAL DIAGNOSIS:successful emesis - no chocolate in vomitusCLIENT COMMUNICATION:did not bring up chocolate, just foodsuspect low intake, but icing very sugary, may get GI upset/signsDIAGNOSTICS:nilTREATMENT:apomorphinemetoclopramidePLAN:homeVisit Vet: Dr Sara Baileynote details from 2023-11-04:REGULAR VET: {__}AES VET: Sara BaileyTIME: 23.30REASON FOR PRESENTATION:ate chocolate icingHISTORY:ate chocolate icing at home - brought in for emesisCURRENT MEDICATIONS:nil medications or supplementsEXAMINATION:Mentation: BARCardiovascular: no murmurs or arrhythmias - HR 132Respiratory: normal lung sounds all fields, no discharge from naresBody condition score:  7/9Weight: 32.5kgAbdo: soft and comfortableMusculoskeletal: ambulating well x 4 limbs. ortho exam not conductedNeurological: appropriate mentation and ambulation in clinic. full neuro exam not conductedEyes/Ears/Skin: NADUrogenital: NADLymph nodes: WNLHydration/volume status: euhydrated, euvolemicPROBLEM LIST:chocolate ingestionASSESSMENT and DIFFERENTIAL DIAGNOSIS:successful emesis - no chocolate in vomitusCLIENT COMMUNICATION:did not bring up chocolate, just foodsuspect low intake, but icing very sugary, may get GI upset/signsDIAGNOSTICS:nilTREATMENT:apomorphinemetoclopramidePLAN:home    Vital Signs    Weight: 32.5;