C09973864 / invoice 10000

Reason: DiarrhoeaAppointment Notes: Booked Online: 02/03/2026 08:20:50 AMBooking Type: UnwellBooking Notes: Diarrhoea Owner Name: meagan auspreadboroughOwner Email: georgemas819@gmail.comOwner Mobile Number: 0400095687Pet Name: TobyPet Species: DogWeb BookingClient name: auspreadboroughContact number: 0400095687Email address: georgemas819@gmail.comPatient name: TobyReason: History: Nurse JCEatting and drinking is fine, No vomiiting.However, since last Monday, Toby has had very soft stools, which became watery on Tuesday and Wednesday. After receiving advice from us, the owner started feeding Toby plain chicken and rice, which helped improve the stool consistency to soft. But on Thursday, Toby's stools became gravy-like again.Last week, O noticed that Toby chewed on a large piece of plastic toy.Diet: Prime 100 SPD puppy food, mixed with a small amount of adult beef and carrot food to gradually introduce adult food.Beef bone soup has been offered as a food supplement.PP UTDLast dose was Virbac tapewormers a month agoMeds taken: Nil Today is for checking diarrhea issueHISTORY:  Toby presented for investigation of diarrhoea of one week's duration. The owner reported that the diarrhoea commenced last Monday with soft stools, progressing to watery diarrhoea on Tuesday and Wednesday. The stool consistency was described as a score of 6/7, and at its worst, was like "water from a tap". There was transient improvement to a soft consistency (score 5/7) after being fed a diet of plain chicken and rice, and stools even became solid briefly. However, the diarrhoea recurred on Thursday with a gravy-like consistency and has persisted. This morning, Toby was unable to control his bowels, resulting in multiple (6-7) episodes of diarrhoea inside the house.The owner suspects the issue may have started after Toby consumed beef bone soup on Sunday, as the meat was later found to be off. Concurrently, Toby chewed up a plastic toy, but the owner believes no parts were ingested. There was a single episode of yellow vomit last Monday, preceding the onset of diarrhoea, with no subsequent vomiting. The owner also noted a small amount of fresh blood on wiping Toby's bottom on Tuesday, likely due to straining.Despite the diarrhoea, Toby remains bright, alert, and very active with a strong appetite. He is described as being very hungry. There is a history of a sensitive stomach since puppyhood, with previous episodes of diarrhoea that resolved quickly.Current diet is Prime 100 SPD puppy food, which has been mixed with small amounts of adult beef and carrot food. Current meds: noneVaccination: Not mentionedParasite Prevention: UTD. Last dosed with Virbac tapewormer one month ago. The next dose is due on 22/03/2026.Pre-existing conditions: Sensitive stomach with intermittent, self-resolving diarrhoea.Access to toxins eg. Rodenticide:none TRIAGE:HR: noneRR: noneTemp: 38.2Mm:  noneCrt: noneMentation: Bright, alertDemeanour/Behaviour: BAR, very active and energetic during consult. EXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0/4Hydration status (%): hydration clinically adequateCardiovascular: cardiac auscultation normal, normal rhythm, pulse pressures normal and synchronousRespiratory:thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological:neurologically no significant findingsMusculoskeletal: ambulating normally, no palpable neck, spine, limb or joint painGastrointestinal:Oral: normal, no mouth pain, dental score (1-4):not gradedAbdominal: no detectable pain on abdominal palpationRectal: not performedUrinary: NSFReproductive: NSFIntegument/Ears: NSFLymph Nodes: NSFEyes: NSFDemeanour/Behaviour: BAR, very active and energetic. PROBLEM LIST:Acute-on-chronic diarrhoeaTensemusHaematochezia (minor, likely from straining)Polyphagia DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:Dietary indiscretion / food-borne gastroenteritisIntestinal dysbiosisProtozoal infection (e.g. Giardia)Viral enteritisBacterial enteritis (e.g. Salmonella)Intestinal foreign body (less likely) DIAGNOSTICS:A faecal sample was submitted for a comprehensive PCR panel to investigate for viral, bacterial, and protozoan causes of enteritis. ASSESSMENT: Toby, a young dog with a history of a sensitive stomach, presented with a one-week history of acute-on-chronic diarrhoea. The clinical signs are most consistent with gastroenteritis, likely secondary to dietary indiscretion (consumption of off meat). While foreign body ingestion is a differential, it is considered less likely given the duration of signs and the absence of vomiting. Physical examination was largely unremarkable, with Toby being bright, active, and afebrile. The primary concerns are the persistent nature of the diarrhoea despite initial dietary management and the underlying gut sensitivity. Diagnostics have been initiated to rule out infectious causes. The initial management will focus on dietary modification and supportive care to promote gut recovery. TREATMENT:  Medications prescribed: Pro-Kolin+ paste, 6mL PO BID for one week. This contains probiotics, prebiotics, and a binding agent (kaolin) to support gut health and firm the stools.Dietary modification: Recommended a strict diet of a prescription gastrointestinal food for a minimum of 1-2 weeks to allow the gut to recover. All other foods, including treats and home-cooked meals, are to be withheld for at least 2-3 months due to his underlying sensitivity. PLAN:The faecal PCR results are pending and will take approximately one week. The owner will be contacted with the results.A strict diet change to a prescription gastrointestinal formula is recommended for 1-2 weeks. If clinical signs resolve, his normal diet (Prime 100) can be slowly reintroduced. If diarrhoea persists, he may need to remain on the therapeutic diet long-term.The owner was advised to monitor for any worsening of clinical signs, such as lethargy, inappetence, or vomiting, and to seek immediate veterinary attention if these occur.A re-evaluation is recommended if the diarrhoea does not show signs of improvement within 48-72 hours.Long-term management options for his sensitive gut, such as a daily gut health supplement, were discussed if issues persist.Home into owner's care. CLIENT COMMUNICATION:A detailed discussion was had with the owner regarding the likely cause of the diarrhoea being dietary indiscretion exacerbating an underlying sensitive gut. The importance of a strict diet change to a prescription gastrointestinal food for at least 1-2 weeks was emphasised, along with the complete cessation of treats and human foods for 2-3 months. The use of Pro-Kolin paste was explained, with the expectation of seeing firmer stools within 24-48 hours.The rationale for faecal testing was discussed, explaining that it will rule out infectious causes like parasites, viruses, or pathogenic bacteria which may require specific treatment. The owner was informed that the results would take about one week. The owner consented to the diagnostic plan. The need for behavioural training was also briefly discussed as a long-term goal to improve his manageability. The owner has pet insurance and an insurance claim will be submitted.    Vital Signs