C09981668 / invoice 10000

Presented and seen by Dr Harris Boubis @ 23:03 02/03/2026Regular Vet:Presenting Problem: Vomiting since 4:00 a.m. today.History:Four episodes of vomiting today.- First vomit at 4:00 a.m. (medium size).- Second vomit after eating at approximately 6:30 a.m. (large volume, included food and tablets).- Third vomit at 4:00 p.m. (large volume). A photo showed a possible fruit-like foreign object in the vomitus.- Fourth vomit at approximately 10:00 p.m., 1.5 hours after Ondansetron administration.Owner administered Ondansetron 4mg at 12:00 p.m. and 8:30 p.m.Attended daycare on 27/02/2026 and has previously returned from there with gastrointestinal upset. No diarrhoea. Vomit is yellow, no blood reported.History of ingesting foreign objects requiring induction of emesis, no history of obstruction requiring surgery.Other dog in household is well, did not attend daycare.Any current medications:- Gabapentin- Clonidine- Fluoxetine- No recent dose changesAny access to potential toxins?: Unsure, possible ingestion of fruit-like object.E/D/U/D: Not drinking. Not eating. Urination/defecation not reported.Any known conditions: Anxiety.Preventatives up to date? YExamination Findings:General demeanour: Bright, alert, responsive. Temperature: 38.4°C.Cardiovascular: HR 120 bpm. No murmurs or arrhythmias. MM pink, CRT <2s.Respiratory: Panting.Oral exam: MM pink; CRT 2s; slightly tackyAbdomen: Mild discomfort on palpation.Peripheral LNs: Not assessed.Eyes/Ears: Not assessed.Integument: NSFMusculoskeletal: WNL.Gait: WNLNeurological: BARRectal exam: Not performed.Urogenital: Not assessed.Body Condition Score: 5/9Initial Assessment:Acute vomiting.Client Communication:Discussed potential causes for vomiting including gastroenteritis from daycare, foreign body ingestion, or infection. Explained that the current dose of Ondansetron may be sub-therapeutic for her weight. Discussed diagnostic options including blood tests and radiographs to rule out obstruction or other underlying causes. Given her stable demeanour and anxiety, discussed outpatient management as a reasonable first step to avoid hospitalisation stress. Plan for symptomatic treatment with an anti-nausea injection and adjusted oral anti-nausea medication at home was agreed upon.Laboratory: Not performed.Radiographic Findings: Not performed.Ultrasound Report: Not performed.Current problems:1. Acute vomiting.2. Mild abdominal pain.Differentials:- Infectious gastroenteritis (e.g., from daycare).- Dietary indiscretion / Foreign body ingestion.- Pancreatitis.Prognosis: Fair.Treatment:- Maropitant 1mg/kg SC 11.20pm.- Advised on appropriate Ondansetron dosing at home: 12-16mg (three to four 4mg tablets) every 8-12 hours as needed.- Instructions provided for home care and when to return for re-assessment.Plan:- Administered Maropitant injection in-clinic.- Owner to continue with Ondansetron at home at the increased dose.- Monitor for ongoing vomiting, lethargy, or worsening clinical signs.- Re-presentation recommended if signs do not improve or worsen, for further diagnostics (blood tests, imaging).- Bland diet once nausea is controlled.---Daily update emailed to referring vet: YES    Vital Signs    Weight: 27.2;