C09970528 / invoice 10000

HISTORY: 01 Mar 2026 03:51:57 pm KA
hx
- v. constipated - dry poo always
- 3rd episode of constipation (usually ends up clearing it herself)
- today straining to defecate, passed only 3 nuggets, keeps trying

DIET: kibble (hairball and T/D), she refuses other foods, won't eat wet foods

ex
- QAR
- omm pink/moist, crt<2
- hr186, nma
- rr/eff wnl, LS normal
- abdo: nsf, no obvious colon impaction but is tensing up
- wt 4.47kg
- BCS 6/9
- Perianal: bulging anus and perianal region, suspect faecal impaction in distal rectum

sedation
- 0.1ml torb & 0.1ml dom IM  (topped up further 0.1ml dom IM)

rectal exam: golf ball shape of faecal impaction in retroperitoneal anal canal (between pelvis and anal opening)

procedure
- lube and warm water enema, manually broke down impacted faeces from anal canal and removed with digital manipulation
- rectal exam after enema: empty as far as finger can reach, normal pelvic canal,  no swellings or masses, AG small/normal size.  distal anal canal feels dilated (where faeces was impacted).  
- perineal palpation: no reducible hernias
- sedated palpation of abdomen: colon seems empty, faeces palpated in descending colon. 
reversed dom with atipamezole. gave microlax enema

discussed actilax (has tried in past, difficult to  administer ongoing).  movicol sprinkled on food (only eats kibble, refuses wet foods)
O will monitor for symptoms and represent for enema if happens again

HISTORY: 25 Feb 2024 01:41:22 pm PUN

History:
Amore is a 4 year old FS DSH. Owner states Amore sniffed a small amount of Lilly pollen which had fallen onto the ground. Owner states Amore hadn't ingested any of plan, just sniffed it about 90 minutes prior to presenting to the clinic. Owner states Amore is otherwise Bright & Responsive and EDDU. 

Subjective:
Amore is QAR

Objective:
Weight 4.9kg
BCS 4/9
Temp 38.3
EENT clean and clear 
Dental C1/G1 - grade 1
mm pink and moist
Capillary refill time <2sec
HR 188 with no murmur or arrhythmia
Respiratory Rate 24 with clear lung fields 
GIT soft and comfortable upon abdominal palpation 
MSK ambulating well with a normal gait 
LN's peripheral LN's WNL

Assessment:
Amore is Bright & Responsive. Amore is showing no signs of localised irritation. Owner declined a comprehensive blood test in favour of monitoring. 

Plan:  
Discharge into care of owner for monitoring.
WEIGHT: 4.9