C09980215 / invoice 10000

Reason: D++ Every Half An Hour Appointment Notes: Overdue remindersReason: DiarrhoeaHistory: Approx 2 weeks ago Coco started PPS - very nervous/shaking on arrival. Did have lots of treats (new) and since then had diarrhoea.Seen here and put on prokolin - did help her stools firm up, but once off diarrhoea reoccurred and now is worsePreviously o had on chicken, pumpkin, rice when had had diarrhoea, o had weaned back to her normal diet.  Previous to all this was on knibble and dry food, stools perfect. Blackhawk puppy dry and wet. No raw meat in the diet. No gastro issues with humans in the householdO presented today as having diarrhoea approx every hour, sloppy tan colored. No blood. Low energyNo vomitingIs a bit off her food now also Examination: Has put on small amount of weight since last check upQuiet but alertMm pink, crt 1, decidious teethHR 160Chest clearAbdo ascultation slightly tense, no ob fb/intussuption. Marked borbogymus +++T 37.5. Liquid tan colored diarrhoea on thermometerLaboratory: In house BG 6.3mmol/LBloods collected for TAHPStools collected for faecal PCRAdmit for xrays Sedation ACP 0.05mL + butorphanol 0.11mL SCX2 lateral + VD abdo xrays: Poor serosal detail (puppy) throughout. Gassy in colon. No ob fb/intussusception noted. Assessment: Diarrhoea (chronic) - open ddx. Dietary embarrassment/food intolerance, parasitic, bacterial, viral, cannot exclude slow moving fb, intussusceptionEating RC gastro food very happilyAs of 4pm no diarrhoea as yet in hospital - still waiting in order to collect a stool sample to send for faecal PCR Treatment: Consent has been given by the client to proceed with this treatment  -  YesMilpro administered in consultMarcopitant 3.6mL SCProkolin 2mL PO BIDPlan:Bland diet as previousAwait blood/stool results    Vital Signs    Weight: 3.68;       

Reason: Provisional 3rd VaccHistory: - d+ resolved, has had firm stools since yesterday- DUDE normally, O transitioning away from chicken and rice back to kibble slowly - much easier than last time- no concernsExamination: BAREyes nose ears clearPink and moist mmPuppy dentition presentLN palpating okayChest ausc clearComf on abdo palpSkin and coat NADComf gait in consultTreatment: C4 SQNexgard Plan:C5 in 1 yrNexgard monthly    Vital Signs    Weight: 3.45;       

Reason: D+Appointment Notes: Overdue remindersHistory: - d+ since puppy school on Sunday, had loads of different treats there- was trembling +++ at puppy school, took a while for her to settle- d+ has been soft serve style, sometimes liquid, no blood- no v+- great energy and appetiteExamination: BAREyes nose ears clearPink and moist mm, CRT < 2 secNo skin tentLN palpating normallyChest ausc clearComf on abdo palp, no painful rxn, soft abdoSkin and coat NADTemp: 38.7Problem List1) Acute d+Ddx: gastro [dietary vs infectious vs inflammatory] vs extra-gastro [ metabolic vs hepatic vs renal]Advised O- gastro cause most likely - dietary due to different treats at puppy school vs picked up a bug at puppy school vs stress induced colitis from being so stressed at puppy school- pro-biotic w/ kaolin to bind up poo quick- recheck on Friday to see if well enough to do vaccsTreatment: Pro-kolin 2ml BIDPlan:Recheck Friday    Vital Signs