C09970381 / invoice 10000

Reason: V3/4 -L3-  CON3/CON3 - V+, D+Presented and seen by Dr Cassie Laiacona     @ Time/DateRegular Vet: Brimbank Presenting Problem:VomitingHistory:- for the past month appetite has been very reduced, not very interested in food much at all- still been BAR and very energetic - this morning at about 10am had 2x vomits of greyish liquid, no blood or food- soon after this passed a solid stool with some fresh blood , no diarrhoea- refused breakfast but has otherwise still been bright and happy - shared custody with ex partner so lives between 2 houses, does get dried bones but not typically a scavenger of FB eater- main diet consists of BH puppy or sensitive gut kibble - UTD with NGS and vaxExamination Findings:General demeanour: BAR a little nervous to examineTemperature: 39.2Cardiovascular: hr 140 bpm mm tachy pink approx 5% dehydrated no m/aRespiratory: panting chest clearOral exam: nsfAbdomen: a little reactive on palpation, possible intestinal thickening mid abdomen vs faeces Peripheral LNs: nEyes/Ears: nIntegument: nMusculoskeletal: nGait:nNeurological:nRectal exam: n/aUrogenital: nBody Condition Score: 5/9Initial Assessment:DehydrationMild abdominal discomfort Acute onset vomitingHaematocheziaDdx: GIFBO, infectious/inflammatory gastroenteritis, endocrine dz (addison's, etc), coagulopathy/IMT or otherClient Communication:Discussed options (admission for IVF/bloods/abdo imaging vs outpatient care and follow up with RV tomorrow) and possible differentials including GIFBO given age and breedO concerned about how Joey will manage in hopsital as anxious dog O elected to take home for today to observe and will represent if any vomiting persists or signs progressAware of risks Laboratory:Admin panel only - lytes all normalBlood gas normal PH 7.407HCT 56%K 4.1mmol/LNa 149mmol/L Ca 1.35mmol/LCl 118mmol/LGlu 5.2mmol/LLac 1.2mmol/LUrea 5.7 mmol/LCreat 103 umol/L base ecf -1.8HCO3 22.3 Prognosis:FairTreatment:Elected to avoid anti emetic today in case masks underlying dxPlan:O to offer lectade and gastro canned food today - small meals every 2-4hrs Any further vomiting or deterioration advised revisit for admission for xrays/hosp/ivf Daily update emailed to referring vet: YES/NOFinancial update provided to owner: YES/ NO    Vital Signs    Weight: 26.3;