C09978313 / invoice 10000

VET/NURSE PERFORMING CALL:
Mikaella

CLIENT NAME:
Gary Foster

REASON FOR CALL:
Follow-up on Hamish's condition and ongoing paracetamol use

PATIENT NOTES:

* Hamish is stable; no new issues or worsening of condition reported.
* Appetite normal; eating well at usual times.
* Water intake primarily via food; not drinking directly from water bowl.
* Mobility being gently restricted to prevent running or jumping; patient coping well.
* Occasional mild discomfort noted; no vocalization or overt pain behaviors observed.
* Paracetamol (Panadol) being administered mornings and nights; confirmed can be continued on an as-needed basis.
* Owner unsure when to administer if signs of discomfort occur; advised to observe for changes in limping or activity, and administer as needed.
* No other abnormalities observed; no gastrointestinal or urinary signs reported.
* Behaviour and activity otherwise normal; patient alert and responsive.
* Communication plan: Mikaella to confirm with treating vet (Dr Vicky) regarding side effects and safe long-term use of paracetamol; update to be sent via text.

REVISIT DATE:
TBC per treating vet

OB CALL ID:
3532075693

Comms Team to paste into Open. Add Visit for the date of the call. Mark note as Complete.
VET/NURSE PERFORMING CALL:
Lesette

CLIENT NAME:
Gary

REASON FOR CALL:
Check-in re: current meds, response to tx, and clarify med instructions.

PATIENT NOTES:
- On Metacox and Panamax (paracetamol), as per previous instructions.
- Metacox being administered ongoing. Paracetamol reported as quarter-tab in AM; duration for 7 days needs clarification (to confirm with Dr. Vicky).
- Improved since last night—more comfortable, less restricted movement.
- Prior diarrhoea episode w/ Meloxicam, no recurrence since.
- Eating initially ?, has returned to normal intake.
- Client advised Panamax course intended for 7 days—pending confirmation; will follow up.
- Booked phone review in 3 days.

REVISIT DATE:
21/02/2026 (phone review, 15:10)

OB CALL ID:
3521002146

Completed by Dr Oosthuizen
Consultation Date: 10/01/2026 18:29 AEDT
HISTORY
Presenting complaint:
- Bloody diarrhoea reported first at 10:00 AM and again at 5:00 PM, described as raspberry-jam-like and significant in quantity, with blood noted around the anus and continued dripping.
- No vomiting reported.
- Owner observed limping and pre-existing problem with legs, history of “collapsing” episodes of legs.
- Patient remains alert, able to walk, and has been eating and drinking since the diarrhoea began.
Current medications & medical conditions:
- On Meloxicam for arthritis; has been used long-term.
- Also receiving a 10 mL/day oral arthritis supplement.
Diet:
- Primarily fed home-prepared fresh chicken and vegetables.
- Occasionally receives fish and egg or yoghurt.
- Biscuits reintroduced recently.
- No beef given due to food sensitivity.
- Occasional pizza or sausage end-bits, infrequently.
- Puppy and senior milk given as treats (recently over Christmas, and newly purchased).
- Typically avoids treats at Christmas, no recent dietary indiscretions other than those noted above.
Client concerns:
- Concerned about sudden onset of bloody diarrhoea.
- Worried about possible causes and the risk of dehydration.
- Aware of association between Meloxicam and potential gastrointestinal side effects.
- Noted long-standing mobility issues and decline in mobility despite current management.

PHYSICAL EXAM
Mentation: BAR
Eyes: NAD
Ears: NAD
Nose: NAD
Aggressive
Musculoskeletal: Limping and previous leg “collapsing” episodes, reduced mobility; known joint issues
Neurological: NAD
Skin & Coat: 5/5
Anal Sacs: NOT DONE
Temperature: 38.5°C
Notes:
- Panting and mild drooling observed during examination, especially under restraint/stress.
- Tolerated rectal temperature.
- No palpable masses or polyps per rectal examination.
- Owner reports increased stress due to veterinary visits and handling. (Aggressive)
- No dehydration signs on exam.

DIAGNOSTICS
- Clinical Examination

ASSESSMENT
- Acute haemorrhagic diarrhoea (most likely localised to the distal colon/rectum)
- Chronic osteoarthritis/degenerative joint disease with ongoing mobility concerns
- Recent administration of Meloxicam (potential contributory factor to diarrhoea)
- No evidence of dehydration, vomiting, or systemic deterioration at the time of visit
- Appetite and thirst preserved

TREATMENT
- Meloxicam ceased due to potential gastrointestinal side effects
- Administered antiemetic/antispasmodic injection onsight, for control of abdominal discomfort and prevention of vomiting
- Dispensed oral gastrointestinal protectant/paste to gel faeces and soothe colon
- Recommended continued small, bland meals (e.g. steamed or rolled chicken in small amounts tonight)
- Can dilution of puppy milk if offered for hydration
- Conservative, at-home care recommended provided symptoms do not worsen
- Owner advised to closely monitor for further diarrhoea, vomiting, or reduced intake
- Admission with IV fluids and further treatment discussed as option if deterioration occurs. Owner are hesitant because of the dog's personality(aggression) . Will need sedation if staying in hospital

COMMS
- Owner declined hospital admission and intravenous fluids at this stage, preferring conservative home care
- Owner aware of need to return for reassessment if clinical signs persist or worsen (diarrhoea, vomiting, or reduced alertness/feeding)
- Owner instructed to discontinue Meloxicam
- Dietary recommendations discussed and accepted, including bland food and avoidance of treats