C09970761 / invoice 10000

Reason: L4: D+ 24hrs, still eatingHISTORY:- Bonnie has had diarrhoea for the last 24 hours.- She is still eating happily and is bright and alert.- There is a possibility of contracting something from the dog park.- Pre-existing conditions: No known pre-existing conditions.- Access to toxins: No known access to any toxins, bait, rubbish, medications, chemicals nor anything else that could have been scavenged.- Current vaccination status: Fully vaccinated.- Current medications: nil mentionedTRIAGE:- HR: 130 bpm- RR: 20 breaths/min- Temp: 38.0°C- Mm: Pink- Crt: <1 second- Mentation: BAR- Hydration status (%): Adequately hydrated.EXAMINATION:Body Condition Score: 9/9Pain Scale (0-4): 1Cardiovascular: 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, no cranial nerve or proprioceptive deficits/gait, full neurological exam not performedMusculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performedGastrointestinal:- Oral: Not performed as patient is very head shy.- Abdominal: NSF- Rectal: not performedUrinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: NSFLymph Nodes: WNL on palpationEyes: NSFDIAGNOSTICS: Nil performed.PROBLEM LIST:1. DiarrhoeaDIFFERENTIAL DIAGNOSIS:Dietary indiscretion is suspected. Other potential causes include gastrointestinal versus extra-gastrointestinal aetiologies.ASSESSMENT:Presented for a 24-hour history of diarrhoea. On examination, Bonnie is bright, alert, responsive, and well-hydrated. Vital signs are within normal limits. The primary suspicion is dietary indiscretion causing the diarrhoea, although other gastrointestinal and extra-gastrointestinal causes have been considered. The owner has requested antibiotics for treatment.TREATMENT:Metronidazole 100 mg orally, twice daily for six days.PLAN:- Discharge home with oral medication as prescribed.- Advised a recheck with the regular veterinarian in the next three days if there is no improvement or if symptoms worsen.CLIENT COMMUNICATION:DISCHARGE INSTRUCTIONSPlease read through the following instructions to help guide your pet’s recovery. Do not hesitate to contact us at any time if you have any concerns or questions, and please let your vet or our client care team know if you have any questions about this information before you take your pet home today. Diagnosis: GastroenteritisYour pet has been diagnosed with diarrhoea of unknown cause. Diarrhoea can be caused by something as simple as a change in diet, scavenging behaviour or infections from worms, bacteria or viral infections. Supportive treatment is often required to prevent dehydration and will include intravenous fluid therapy, pain relief, anti-nausea medications and possibly antibiotics. If your pet responds well to supportive treatment no further work up will be required, however if the diarrhoea is not responding then further investigation is warranted to ensure there are no more serious underlying conditions that require specific treatment. Diet:To facilitate your pets recovery it is recommended that you feed small frequent meals of boiled chicken over the next 3-4 days. Ensure that water is available at all times.  If after this time your pet is well, then gradually transition them back to their normal diet - mix the normal diet with chicken and rice in increasing proportions over the next 3 days.Exercise:Please keep your pet rested for the next 2-5 days then gradually reintroduce normal activity over the following week.Medications dispensed :Metronidazole 200Mg Tabs Give HALF tablet TWICE daily. Medications to start from home if needed: Paracetamol 48mg/mL LiquidGive 2ml TWICE daily as pain relief for the next 3-5days. Recheck:Once your pet is discharged home we advise a reassessment with your primary care veterinarian within 48 hours to monitor your pets progress.  If your pet's condition deteriorates, they become flat or lethargic, go off their food and water, develops vomiting, has continued diarrhoea or if you have any concerns please contact our team or your primary care veterinarian immediately. If your pet is going home and has a pressure wrap over where an IV catheter was placed please remove it within 20 minutes of leaving the hospital.Thank you for trusting our team with the care of your pet.    Vital Signs