C09981393 / invoice 10000

Reason: Seen at Northside Veterinary Emergency for out of hours urgent/emergency.Patient history attached.History:Presented to NEVS last night. Acute behavioural change, lethargy, weight loss and mild tachypnoea; physical exam largely unremarkable.Initial bloods: CBC/biochem/T4 WNL; PCV/TP 32/84. Electrolytes showed inconsistent hypokalaemia (K = 2.9 on 1.9-2.2 on ABL [3.5-4.8]) with repeat normalisation to 3.6, suggesting sampling/artefact. Given fluids with K supplementation. Imaging (thoracic/abdominal rads) NAD; no structural cause identifiedVery difficult to handle. HIGHLY reactive to needle and touch Catheter not patient. No long line. Fluids not labelled. - had to replace all. Sedation: 0.5ml alfaxan IM - not enough 0.5ml alfaxan IM - not enough 1ml alfax IM - not enoughMedetomdine 5mcg/kg + alfaxan 0.2ml IM - not enough Medetomidine 5mcg/kg + torb 0.2mg/kg Reversed with antisedan 0.03mls.Discussed with owner 3 options:1. Stay in hospital on fluids and symptoms observation as potassium has returned to normal. Serial blood results throughout the day. 2. Continue investigation with abdominal ultrasoundLaboratory:K = 1.9 --> 2.9 --> 3.6 --> 3.7 --> 4.1In hospital: Very bright in hospital. Purring when approached Eating food very well Large palpable bladder. Soft. Attempted to express under GA - only few drops. Assessment: Potassium back to normal without supplementation (other than Hartmanns fluids) Treatment:Hartmanss fluids at maintenancePlan:Strict monitoring of symptoms at home If not improved or at any point worsening then recommend return for abdominal ultrasound.    Vital Signs    Weight: 5.42;       

Reason: Health Check & VaccAppointment Notes: MD ( Bob aware Appt had to be from midday so couldn't see LS)Subjective and History: Routine vaccination.Doing well, no health problems reported. Bright, alert and responsive. Eating, drinking, defaecating and urinating normally.No v+/d+Indoor and outdoorWet food only sx hx of constipationPhysical Exam: BAR, nervousBCS 4/5, sl weight incrMM pink, CRT <2sec, grade II dental, mod tartar upper premolarsHeart/chest ok, no murmurAbdo ok, sl tenseLN okCoat okAssessment: Fine to proceed with vaccinationTreatment: 1. F2 SQ Plan: Monitor weight- recc weight loss    Vital Signs    Weight: 5.75;       

Reason: AHC Appointment Notes: ssSubjective and History: Routine vaccination.Doing well, no health problems reported. Bright, alert and responsive. Eating, drinking, defaecating and urinating normally.Indoor and outdoor Bravecto topical- duePhysical Exam: QAR, nervousBCS 4/5, weight stableMM pink, CRT <2sec, grade II dentalHeart/chest ok, no murmurAbdo okLN okAssessment: HealthyFine to proceed with vaccinationTreatment: 1. F3 SQ2. Bravecto topical + 1 tgh    Vital Signs    Weight: 5.59;       MMColour: pink;       HeartRate: 180;       DentalGrade: 2;       CRT: <2sec;