C09974564 / invoice 10000

Reason: EcC - V+ Since Last NightDr Salena Hubacker 1/3/26 9pmHISTORY:  The patient presented for brown vomiting since last night. The owner reported one episode of vomiting in the last 30 minutes prior to presentation, which appeared to contain grass and liquid and previous vomits showed some white spongey material - unknown maybe from the yard. The patient had eaten grass before the vomiting started. There is a decreased appetite, which is more significant than the patient's usual pickiness. The normal diet consists of pet food and treats. The owner reports no diarrhoea. The patient is known to chew on plastic and toys. The owner noted that something was chewed up in the living room at home. The patient also sometimes consumes human food from a table. The patient is not spayed. Otherwise healthyCurrent meds: noneVaccination: Not mentionedParasite Prevention: Not mentionedPre-existing conditions: noneAccess to toxins eg. Rodenticide:noneExamination Findings: Temperament: BAR and friendly but a little nervousHydration:  5% dehydratedEyes/ears/nose: No significant findingsOral Cavity: No significant findingsLymphatic: No peripheral lymphadenopathyCardiovascular: Mild tachycardia, sinus rhythm, no murmurs. Moderate and synchronous pulses bilaterally.MM color pinkCRT: CRT <2Respiratory: Normal respiratory rate and effort.  Auscultation of lungs - No significant findings.Abdominal: Mildly painful in cranial abdominal palpation. No palpable masses, organomegaly or fluid wave notedMusculoskeletal: Ambulatory x 4 with no apparent pain, lameness or joint effusion. Normal muscle mass and toneBCS: 4/9Urogenital: Prominent vulvaIntegumentary: No significant findingsNeurological: Normal neurologic exam with normal mentation.  No proprioceptive deficits or overt ataxia; full neuro exam not performed. Rectal: Normal faeces on rectalPROBLEM LIST:- Vomiting (brown fluid, grass)- Hyporexia- Mild abdominal tenderness- Mild dehydration- History of ingesting foreign material (toys, plastic) DIFFERENTIAL DIAGNOSIS/ DIAGNOSIS:- Gastroenteritis (dietary indiscretion)- Gastrointestinal foreign body (irritation or obstruction)- Pancreatitis (secondary to rich/fatty food ingestion)- Systemic disease (e.g., renal, hepatic) causing secondary nausea (considered less likely)- Toxin ingestion (considered less likely)- other DIAGNOSTICS:POCUS: AFAST brief - no faf; stomach still slighty distended with gas; no severely dilated loops of intestine; no obvious fluid filled uterus.  TREATMENT:  Maropitant 1mg/kg Sc once 950pmBuprenorphine 0.3mg/ml: 0.2mL SC 950pm PLAN:The patient is to be discharged home into the owner's care. The owner has been advised to feed a bland diet (plain boiled chicken and rice, with no seasoning, oil or skin) in small, frequent amounts, starting tomorrow morning. No food should be offered tonight. The owner will monitor for any further vomiting, changes in demeanour, or worsening of clinical signs. Strong recommendation was made for follow-up with their regular veterinarian tomorrow for further diagnostics, such as blood tests and imaging (radiographs), as the injections can mask clinical signs of a more serious underlying issue like a GI obstruction.  CLIENT COMMUNICATION:A detailed discussion was had with the owners (translated by family member) regarding the possible causes of the vomiting, which include gastroenteritis, a foreign body obstruction, and pancreatitis. Three main options were presented:1. Gold standard care: Hospitalisation for intravenous fluids, in-house blood tests, and advanced imaging (ultrasound), with an estimate of around $2000 for hospitalisation and bloods, and an additional $1000 for X-rays or $1500 for a specialist ultrasound tomorrow.2. Intermediate option: Hospitalisation for IV fluids and blood work overnight, with imaging to be pursued at their regular vet tomorrow.3. Outpatient management: Administering injectable anti-nausea and pain relief medications and discharging home with strict instructions for follow-up.The owner was informed that while an anti-nausea injection will stop the symptom of vomiting, it does not treat the underlying cause and can mask the progression of a serious condition like a foreign body obstruction. The significant risks associated with an undiagnosed GI obstruction were explained, including the potential for intestinal damage. The owner was advised that the cost for two injections (anti-emetic and analgesic) and the consultation would be approximately $400. The owner elected to proceed with outpatient treatment and will monitor the patient at home, with plans to follow up with their regular veterinarian in Strathfield.Referral Vet Communication: --- 01/03/2026 22:09:39 SLH: records sent    Vital Signs    Weight: 5.4;       MMColour: pink;       Temperature: 37;       HeartRate: 160;       RespirationRate: panting;       CRT: 1.5;