C09976204 / invoice 10000

Referring Veterinary Practice:Ok to send Hx to rDVM: Yes History:Think he might have ingested some bark yesterday as saw him chewing on it around 6pmStarted huffing like trying to clear his throat a few times yesterday and last nightWas dry retching and then coughed up foamy salivaStill energeticEating, drinking fineJust starts coughing when he tries to sleepVisited a doggy daycare on Saturday Vax: UTDTick prevention: Nexgard done on 21st each monthWas fed at 8pm.Ran around like his normal self at the parkBeen on A/B for a week after getting bitten by a dog last weekIncreased his food intake by 30gm each meal since Tuesday AMRaw feed + kibbleIs a fast eaterUsed to scoff his food when he was younger and throws up afterDid not like the slow feederExamine:BARPantingSingle incident of clear white foam retchOral cavity - no obvious fb (Winston was shaking head alot)Chest ausc - no murmurAbdo palp - comfortableAmbulating stronglyBCS 3/9Assessment:DDx Acid reflux vs indigestion vs dietary indiscretion vs otherTreatment:Maropitant 1mg/kg SC @ 11pmClient Discussions: Discussed sedation to examine back of throat +/- radiographs as they thought there may have been bark ingestion However, decided against as Winston was not actively retching whilst here and given the risk of sedation having had dinner just 2+ hrs agoOwners then recalled additional hx re recent A/B and increased feeding Happy to trial outpatient tx and understand that anti-emetic does not help directly with retching but probiotics may be helpful to re-establish gut microbiome following completion of A/Bs and as Winston is on a raw diet as well.Recommended that they consider a MED assessment as Winston has been noted to be a very good eater but is underweight.Plan:Reduce feed portions to control gobbling Prokolin 3ml PO BID x 5 days (just completed A/B course)Consider MED for investigation if does not resolve    Vital Signs    Weight: 8.8;       MMColour: pink;       Temperature: unable;       HeartRate: 116;       RespirationRate: panting;       CRT: < 2s;       

Reason: Ate Bark, Stuck In ThroatAppointment Notes: RQ    Vital Signs