C09975765 / invoice 10000

Reason: Swollowed A ScrunchyAppointment Notes: Overdue remindersConsultation Time: Hospital Time Period: History:Subjective:Objective:Temp:            MM:              CRT:             HR:             FP:              RR:BCS:    /9                Wgt:    kg Pain Score (CSU):   /4CV:    RESP:              GIT:   U/G:  Neuro:  M/S:  Integ:  Ophth:  LNs: Initial Tests:INTERNAL LABORATORYPCV/TS:(Dog: PCV 37-55%, TS 55-75 g/L)(Cat: PCV 30-45%, TS 62-81 g/L)LACTATE:   mmol/L	Blood Gas(sample type: arterial/venous)Abnormal parameters:Interpretation:CBCAbnormal parameters:Blood smear examination:BiochemistryAbnormal parameters:PT:APTT:UrinalysisCollection method: cystocentesis/urinary catheter/free catchpH:   Protein:   Glucose:   Ketones:   Urobilinogen:   Bil:   Ery:   Hb:USG:Sediment examination:EXTERNAL LABORATORYLab No: 	***** PENDING *****Sample: Interpretation:IMAGINGAFAST:TFAST/Vet Blue:Radiography:Problem List:Assessment: Options Offered to Client:Financial update (deposit, estimate communicated):Referring Vet Communication: Treatment:  	Plan: Diagnostic plan :Therapeutic plan :Discharge plan :Referral plan :    Vital Signs    

Reason: History: Examination: Laboratory: Assessment: Treatment: Consent has been given by the client to proceed with this treatment  -  Yes/No Plan:    Vital Signs    

Reason: V+++Appointment Notes: Overdue remindersReason: Acute onset vomiting History: Angus Mac presented today for assessment after acute onset vomiting this evening. Angus was last normal this afternoon and was eating and playing as usual. Later in the evening, owners noted 2 vomits outside that contained grass. Angus passed a normal stool around 1 hour ago. During the final vomiting episode there was profuse hypersalivation. He has remained relatively bright throughout the event and owner did not offer any food but feels that he would likely eat if offered. His normal diet is raw food that is freeze dried with additives such as chia seeds and greek yoghurt. Was given yoghurt and chia seeds this morning which he has had before but not in recent days Angus is a known scavenger and will eat anything he finds. He has no access to known toxins and owners are very careful as they also have small children in the home.Angus was given his normal dewormer yesterday afternoon and was normal after. No significant medical history aside from some diarrhoea when he first arrived from interstate on a plane.Prior to this he was a normal puppy - normal appetite, growing normally, no PU/PD. He is UTD with vaccination and worming. No current medications. Since being in the waiting room - Angus has returned to normal and has had no vomiting episodes but owner wanted him assessed anyway. Examination: Very BAR - jumping, nipping during examTPR: T: 38.9, P: 160, R: 36, MM: pink and moist, CRT: < 2sec, euhydratedEENT: WNLPLN: Soft, symmetrical, normal size/character.Cardiovascular: No murmur or arrhythmia noted - however, extremely wriggly during examination. Pulmonary: Normal lung sound and effort. Lungs clear bilaterally.Abdomen: Soft on abdominal palpation - query mild abdominal pain on deep palpation, however, likely behavioural. No palpable foreign bodies. Musculoskeletal: NormalIntegument: Healthy hair coat. The skin is clean, dry, and intact.Neurologic: Normal Laboratory: None performedAssessment: Problem list:1. Acute vomiting - Ddx: dietary indiscretion vs transient GI upset secondary to diet change vs infectious gastroenteritis vs gastrointestinal foreign body vs other. Treatment: None Plan:Options: 1. Admit for sedation and abdominal ultrasounds to definitively rule out GI foreign body - however, given how stable and bright he is and the fact that he has had no ongoing vomiting, this was not considered pertinent at this stage. 2. Outpatient monitoring and supportive care. Discussed dispensing anti-emetics, however, explained that if there is a foreign body we do not want to mask symptoms with anti-emetics. Owner did not want to give any medications given his improvement 3. Outpatient monitoring, no treatment. Owner opted for option 3. O to represent if ongoing vomiting, inappetence, lethargy, diarrhoea. Discussed minimising new foods and slow introduction rather than rapid changes to diet.    Vital Signs    MMColour: pink ;       Weight: 8.3;       Temperature: 38.9;       HeartRate: 160;       BodyScore: 5/9;       DentalGrade: 0;       RespirationRate: panting;       PainScore: 0;       BP: -;       CRT: <2;