C09976093 / invoice 10000

Reason: L3 D++++ LethargicREASON: Diarrhoea since yesterday afternoonHISTORY: Hero presented with diarrhoea that began yesterday afternoon. The diarrhoea is watery and greenish brown in appearance. Hero is experiencing frequent defecation of small amounts of faeces. The owner reports that Hero feels a little hotter than usual. There was no vomiting reported and Hero was eating normally yesterday. The owner contacted an insurance online vet last night who advised not to feed Hero, so it is uncertain whether Hero would have eaten today. Two days ago Hero consumed kangaroo steak treats for the first time. Hero usually eats normal dog biscuits and very occasionally has some cooked vegetables. Hero does not have bones or raw food.- Pre-existing conditions: No known pre-existing conditions- Access to toxins: No known access to any toxins, bait, rubbish, medications, chemicals nor anything else that could have been scavenged- Current vaccination status: Fully vaccinated- Current medications: Nil TRIAGE:- HR: 110 bpm- RR: 22 breaths/min- Temp: 38.1°C- Mm: Pink, moist- Crt: 1 second- Mentation: QAR- Pain Scale (0-4): 0- Hydration status (%): NormalEXAMINATION:Body Condition Score: 5/9Pain Scale (0-4): 0Cardiovascular: Heart rate 110 bpm, pulse rate synchronous and normalRespiratory: Thoracic auscultation clear sounds bilaterally, respiratory effort normal, no nasal dischargeNeurological: Alert and responsive, a little watchfulMusculoskeletal: Ambulating normally, no apparent neck, spine, limb or joint pain, full musculoskeletal exam not performedGastrointestinal:- Oral: Dental score 1/4- Abdominal: Gut sounds 4+- Rectal: No abnormalities detected, no faeces presentUrinary: NSFReproductive (incl ext genitalia): NSFIntegumentary system: NSFLymph Nodes: WNL on palpationEyes: NSFDIAGNOSTICS: Nil performedPROBLEM LIST:1. DiarrhoeaDIFFERENTIAL DIAGNOSIS: Intolerance to kangaroo treats versus other dietary indiscretion versus infectious, inflammatory, toxic, neoplastic insultsASSESSMENT: Hero is well hydrated and comfortable. Although appearing a little quieter than normal, Hero appears relatively normal during consultation. Given that Hero is well hydrated and comfortable, and that there was no diarrhoea present on the glove during rectal examination, it is considered likely that Hero has reacted badly to the kangaroo treats and that this is causing the diarrhoea. This should resolve with conservative care.TREATMENT: Prokolin 3 mL twice daily orallyOndansetron 4 mg transmucosal for three doses to support blood supply to the gut and to ensure Hero does not feel nauseous so that Hero eats and drinks and does not become dehydrated.PLAN:- If Hero is not eating and happy by tomorrow, Hero should be seen by usual vet- Monitor eating, drinking and general demeanourDISCHARGE INSTRUCTIONSPlease read through the following instructions to help guide Hero's recovery. Do not hesitate to contact us at any time if you have any concerns or questions, and please let your vet or our client care team know if you have any questions about this information before you take him home today. Treatment summary: Hero has presented with diarrhoea and a little lethargy after eating new treats.  On physical exam he is comfortable, well hydrated and quite normal, which is lovely.  The most likely thing is that the treats have upset his gut and now it is unbalanced.  He is being treated with probiotics and medication to help support blood flow to his gut, to aid healing.  Diarrhoea can take a few days to settle down, as long as he is happy and eating, this is not cause for concern.  He needs to be seen again if he doesn't eat, if he is vomiting, if he is sad or if there is blood in the diarrhoea.Exercise:- Please keep Hero rested for the next 3 days then gradually reintroduce normal activity.Diet:- as normalRecheck:- Please organise a recheck for your pet with your primary care veterinarian in THREE days to assess your pet's improvement unless otherwise advised by your veterinarian.Medications at discharge:Ondansetron Wafer 4mgOne (1) wafer three times a day into the cheek pouch.  Next due at 6.30 tonight, then 2.30 in the morning.Pro-Kolin + Probiotic Paste 30mLGive 3 mL twice daily into the mouth, use until finished.  Start when you get home.If your pet’s condition is not improving or if other problems develop, please call your primary care veterinarian or if it is outside their normal working hours, please call Perth Vet Emergency.  We are open from 6pm until 8am Monday to Friday and 24h over weekends and public holidays. Phone 1300 040 400    Vital Signs