C09970998 / invoice 10000

Reason: Vomiting & DiarhoeaAppointment Notes: Vomiting and diarhoea yesterday with a few blood drops in vomit. Off food today, bloody diarhoea. O aware of cost. ABHISTORY:  1 year, 7 month old female spayed golden retriever cross (22.5kg) presented for vomiting and diarrhoea, which started this morning. Reports lethargy at home. Some red tinge to the diarrhoea, but no large clots. Has been eating grass.Diet is normally Supercote, which was a recent change. Dietary indiscretion suspected. Current meds: noneVaccination: UTD.Parasite Prevention: Due today, advised to delay for 1 week.Pre-existing conditions: noneAccess to toxins eg. Rodenticide: Dietary indiscretion suspected. TRIAGE:HR: 108 BPMRR: 32 per minuteTemp: 38.5 degrees celciusMm:  PinkCrt: <1sMentation: BrightDemeanour/Behaviour: Bouncy, friendly, required firm restraint for examination. EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 1/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronous. HR 108bpm.Respiratory:thoracic auscultation clear sounds bilaterally, respiratory effort normal (RR 32), no nasal discharge.Neurological:neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint pain.Gastrointestinal:- Oral: normal, no mouth pain, dental score (1-4):not graded- Abdominal: Mildly sore on palpation.- Rectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: NSFLymph Nodes: NSFEyes: NSFDemeanour/Behaviour: Bouncy and friendly during consult. PROBLEM LIST:- Vomiting- Diarrhoea with mild haemorrhage- Lethargy- Mild abdominal pain- Dietary indiscretion DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Gastroenteritis- Acute Haemorrhagic Diarrhoea Syndrome (AHDS)- Possible food reaction (recent diet change)- Dietary indiscretion DIAGNOSTICS:None ASSESSMENT:Acute onset vomiting and diarrhoea in a young dog. Examination findings include mild abdominal discomfort but otherwise stable vital signs. Likely diagnosis is gastroenteritis, secondary to dietary indiscretion or a possible food reaction. More serious causes like a foreign body are considered less likely given the clinical signs but cannot be ruled out without further diagnostics. The owner has elected for medical management at this stage. TREATMENT:  - Maropitant 1mg/kg administered subcutaneously.- Pro-Kolin prescribed, 5mL orally twice daily until finished.- Recommended bland diet (Royal Canin Gastrointestinal Low Fat or boiled chicken and rice).- Withhold food and water for the next 4 hours, then offer small, frequent meals (e.g., six times daily). PLAN:Home into owner's care.Re-evaluation is required if vomiting persists, if not eating by tomorrow morning, or if general condition worsens. The owner was advised that diarrhoea might take 2-3 days to resolve.If clinical signs persist or worsen, further diagnostics including blood tests and abdominal radiographs will be necessary.Hold off on worming for one week. CLIENT COMMUNICATION:Discussed likely cause is gastroenteritis from eating something inappropriate. Advised that more serious causes are less likely but possible.Explained treatment plan, including medication administration and dietary changes.Advised on signs that warrant re-presentation: continued vomiting, inappetence, or worsening lethargy.Provided estimate for hospitalisation with full diagnostics ($2000-$2500) if required. Confirmed owner's decision to proceed with outpatient medical management.    Vital Signs    Weight: 22.5;       Temperature: 38.5;       

Reason: 1 Swollen Nipple + Lump Under Chin + Vax If Ok MN(Assisted by: )History & Problems: Nipples look enlarged, licking at them a lotPuffy bit on her lower jaw, has come down since making appointmentEDUD okVomiting a week ago, did eat a coinHPP Status: NVaccinations: due C5 on 21/10/2025Heartworm: NGSWorming: ''Flea prev: ''Current diet: kibble supermarket brandMicrochip: yes scannedCurrent meds: noneExamination: Mentation: BAROral Conformation / Exam: DG 0Ears: looks erythematous but cleanEyes: NADCardioresp: NAD, no murmur GI: NADUrogenital: some scabbing on cranial R nipple, mammary glands not enlarged and not firm, nipples looks normal but poss enlarged?Skin: swelling on R lower lipLymph nodes: NADMusculoskeletal:.NADNeuro: Other:Behaviour: very boisterous, likes treatsProblem List:Laboratory:Assessment: Licking nipples ddx; allergies vs hormonalSwelling on lower lip ddx; allergies, insect bite, abscessVitals normal, O consent for vxTreatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Vanguard C4 vx SC scruff 7044 00305 Exp 11/27Vanguard BB oral 787365 Exp 13 Nov 26O happy to monitor swelling and licking - O thinks swelling improving and licking is not excessivePlan:Sedate and explore if swelling still present or getting worseSpoke about AMH BT to check for hormonal causes of licking nipples--- 09/10/2025 10:32:46 AM BMD:Vaccinations - Resolved - Follow up txt sent. BM    Vital Signs    MMColour: pink;       Weight: 24;       Temperature: 38.6;       HeartRate: 88;       BodyScore: 5;       DentalGrade: 0;       RespirationRate: panting;       CRT: <2s;       

Reason: Post Op Spey. ASHistory: O says she has been dong well at home, very energetic though. Trying their best to keep her settled. Has broken her ecollar by chewing at it. Assessment: Sx site looks good, no bruising, redness or discharge. There is a section of scar tissue on the RHS of wound. Explained that this can occur when the dog is too active and may take longer for the scar tissue to settle. Plan:Sent o home with a new ecollar reinforced with duct tape Advised o to remove cone on friday (10 day mark) and can resume normal activity after that.--- 22/08/2025 11:39:04 SKK:O called saying Lucy was a bit off her kibble. Put down for breakfast yesterday and she didnt touch it until mid afternoon. Didnt want anything for dinner. Ate human food today, still BAR. No v++ or d++. Recc O monitor for the time being. If Lucy becomes flat, lethargic or develops v++ or d++ would recc seeing a vet. O happy to monitor. Will cann back if any concerns SK    Vital Signs