C09973031 / invoice 20000

No improvement with D+ Send off full faecal panel for further analysis Continue pro-kolin and await results - RV if any clinical deterioration     Vital Signs    

Appointment Notes: D+ V+ GW?????History:Presented for vomiting and diarrhoea over the last 48 hours. The patient vomited two nights ago after eating pulled pork. Yesterday, she vomited several times. This morning, she vomited bile and had severe diarrhoea, which progressed from brown to green, with a small amount of blood noted in the most recent stool. Appetite is poor; she has only eaten a small amount of chicken but is drinking water. The patient remains bright and active. Diet was recently transitioned from soft food (post-dental surgery) back to soaked kibble. The patient had her first oestrus cycle on 02/02/2026 and is currently coming off heat. She is walked in New Farm Park and drinks from public water bowls.- Significant history: Extraction of puppy teeth (11/02/2026). First oestrus (02/02/2026).- Current medications: Pro Kolin - administered yesterday. NexGard and other parasite prevention are up to date.- Appetite & diet: Appetite decreased. Normal diet is kibble, currently soaked. Recent dietary indiscretion (pulled pork).Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperemia, no epiphora.- Ears: Ears clean, no malodour.- Oral: Grade 0 dental disease.- Nose: NAD.- Cardiovascular: No murmurs or arrhythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Nipples swollen post-oestrus. Normal coat, no ectoparasites.- Abdomen: Mildly sensitive on palpation, soft, no masses palpated.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Swollen vulva and nipples consistent with recent oestrus.Assessment:Problem List:- Gastroenteritis- Suspect dietary indiscretion- Rule out Giardiasis- Post-oestrusTreatment:- Anti-nausea injection (24hr duration) administered in-clinic.Plan:- Dispense oral anti-nausea medication. Administer half a dose tomorrow, then repeat on Monday.- Continue Pro Kolin as directed.- Feed a bland diet of chicken and rice in small, frequent meals.- Giardia SNAP test performed in-clinic.- In-clinic faecal microscopy: a few inflammatory and blood cells noted, no abnormal bacteria seen.- Discussed external lab faecal testing if symptoms persist. Owner has declined for now.- Recommend a complimentary pre-desexing consultation to assess recovery and nipple swelling before surgery.Client Communications:Advised that dietary indiscretion is the most likely cause. Instructed owner to return immediately if the patient vomits within the next 24 hours, as this could indicate a blockage. Discussed prognosis is good. Owner will consider external lab testing if there is no improvement and will attempt to collect a faecal sample.?????    Vital Signs    Weight: 15.5;       Temperature: 38.4;       

    Vital Signs