C09979528 / invoice 10000

Appointment Notes:  Wang lewiswlm@hotmail.com 0413891386- Cosmo (Dog) - Consultation [Veterinarian : Romilda Au(No Preference)] - diarrhea and vomitingWeb BookingClient name: Lumin WangContact number: 0413891386Email address: lewiswlm@hotmail.comPatient name: Cosmo Original Appointment Type: ConsultationVax not up to date - O said not eating and lethargic LHHistory: D+ last night. Unsettled last night. V+ once 2-3 days ago. No v+ since then.  Watery d+ with mucus. No blood in d+.Lost appetite this morning. Energy seems ok now. Normal diet: Dry food. No wet food or raw meat. No change in diet. Not UTD With worming or flea/tick. Was using nexgard spectra monthly. Examine: BAR, BCS 7/9 DG 1/4 mild tartar mm p+m crt <2sec HR 72 RR pant. Normal RE Abdo palp soft and comfortabel. Rectal palp small pieces of solid stools in rectum. No blood or mucus. Peripheral LNs wnl. Assessment: Acute d+ likely related with dysbiosis. Cannot rule out underlying metabolic dz or infectious causes for GI dz.  Treatment:Prokolin 8 ml POBID until finished  (60 ml tube). INI on d+ in 2-3 days, submit faees for PCR +FF ($350). To restart on nexgard spectra and continue monthly. Return for vaccine when well.    Vital Signs    Weight: 38.2;