C09976167 / invoice 10000

01/03/2026 Triaged by JD (nurse)

BAR
HR: 140
RR: panting
Temp: 39.4
MMCRT: P 1-2s

Hx of V+ on and off since Tuesday. Inappetant past few days. No D+
O not aware of any health issues besides OA

O says reluctant to walk but capable of ambulating


01/03/2026 DATE/TIME of CONSULTATION: 16:53hrs, Sun 01/03/26
CLINICIAN:  EB 
PRESENTING COMPLAINT: vomiting inappetence lethargy  3-4 days 
HISTORY:
older dog but been ok
monthly cartrophen injections with regular vet for OA hips/ hindlegs- not on any other meds
bloods regularly - no Signiant abnormalities  recalled

increasing inappetence and lethargy last 6 days- last ate regular meal monday but eating small treats/pizza up until thursday
some vomiting -large backyard has found some but could be more
no faeces/diarrhoea last couple of days- 
drinking but less 

today  very lethargic and difficulty rising 


CLINICAL FINDINGS: Mentation:  QAR- will bark and carry on around other dogs HR: 140 RR: panting  MM: pale  CRT: <2   Temp . 39.4

Cardiovascular: no notable murmurs or arrythmias auscultated, femoral pulses good and synchronous
Respiratory: normal respiratory rate and effort, normal bronchovesicular sounds on auscultation, no visible nasal discharge
Gastrointestinal:  slightly tense abdomen on palpation, no strong repeatable focus of pain,, possibly some GI thickening cranially  no  obvious mass affect , marked hypersalivation /ptylasiam
Rectal exam: empty -no faeces or obvious diarrhoea 
Musculoskeletal: difficultly rising, marked muscle wastage, did not do a full MSK exam Neurological: cranial nerves intact, no notable ataxia
Lymph Nodes: no peripheral lymphadenopathy noted

PROBLEM LIST:
anorexia ongoing 3 days duration
inappetence 6 days duration
vomiting/nausea
increasing lethargy/reluctant to rise/move 


DIAGNOSTIC TESTS:
pcv/ tp 74/62- polycythemia /dehydration 
EPOC
pco2- 30.3- resp alkalosis- panting/hyperventilation
urea/BUN low

DIFFERENTIALS: dehydration and ongoing GI signs-  1' GIT ie FB vs gastroenteritis vs dietary indiscretion vs 2' GIT ie endocrine organ disease, neoplasia 
reluctance to rise- acute flare of ongoing OA due to immobility/lethargy for GI signs ?

OPTIONS PROVIDED:\
1./admit for fluids medication as required with imaging and bloods as indicated
2/  conservative treatment at home

owner very reluctant to admit at this age- have appointment with regular vet on tuesday- 

TREATMENT
maropitant 1mg/kg sc 
buprenorphine 0.01mg/kg sc 
ondansetron 16mg bid -start in am
recommend paracetamol 500mg bid until revisit 
encourage water intake/broth etc 


CLIENT COMMUNICATION/PLAN:
owner to monitor very closely for ongoing vomiting- if vomits through injection or no improvement in appetite recommend revisit with regular vet or here tomorrow
otherwise revisit with regular Tuesday  at the latest